Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › MA › RANDOLPH › RANDOLPH FAMILY DENTISTRY PC

RANDOLPH FAMILY DENTISTRY PC

NPI: 1184155590 · RANDOLPH, MA 02368 · Dentist · NPI assigned 03/27/2017

$6K
Total Medicaid Paid
180
Total Claims
180
Beneficiaries
4
Codes Billed
2022-03
First Month
2024-10
Last Month

Provider Details

Authorized OfficialSALLOUM, EYAD (DENTIST)
NPI Enumeration Date03/27/2017

Related Entities

Other providers sharing the same authorized official: SALLOUM, EYAD

ProviderCityStateTotal Paid
ULTIMATE DENTAL CARE OF RANDOLPH , PC RANDOLPH MA $23K
NORTON FAMILY DENTAL GROUP NORTON MA $4K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 109 $4K
2023 15 $404.00
2024 56 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 101 101 $3K
D1110 Prophylaxis - adult 25 25 $2K
D1206 Topical application of fluoride varnish 42 42 $1K
D1120 Prophylaxis - child 12 12 $660.00