Dental
Mahmoud Maghsoudlou LLC
Mahmoud Maghsoudlou LLC was paid $44K by Medicaid between Jan 2018 and Mar 2019, across 14 billing codes. Its largest line is D7210, Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth — 32% of everything it billed.
33Billing provider infoMAHMOUD MAGHSOUDLOU LLC
WALLA WALLA, WA 99362
WALLA WALLA, WA 99362
33aNPI1265848014assigned 07/01/2014
33bProvider typeGeneral Practice Dentistry
28Total paid$44K
24GClaims2,920
24DCodes billed14
24AFirst – last monthJan 2018 – Mar 2019
Compared with peers
Next to other General Practice Dentistry providers in Washington
Rank by total paid#141 of 319
Median peer was paid$22K
This provider vs. median2.0×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 2,187 | $34K | |
| 2019 | 733 | $10K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 32% | 285 | 108 | $14K |
| D0150 | Comprehensive oral evaluation - new or established patient | 12% | 281 | 239 | $5K |
| D4341 | 9.5% | 230 | 60 | $4K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.0% | 96 | 49 | $3K |
| D0140 | Limited oral evaluation - problem focused | 6.6% | 192 | 151 | $3K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 6.2% | 85 | 24 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 5.7% | 508 | 441 | $3K |
| D0330 | Panoramic radiographic image | 5.2% | 141 | 124 | $2K |
| D0274 | Bitewings - four radiographic images | 4.5% | 308 | 267 | $2K |
| D1110 | Prophylaxis - adult | 3.2% | 55 | 52 | $1K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 3.1% | 85 | 73 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 2.1% | 99 | 81 | $938.88 |
2 more codes
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialCARRILLO, MANOLO (MANAGER)