Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

ROCKAWAY FAMILY DENTISTRY PLLC

NPI: 1316212897 · JAMAICA, NY 11436 · Dentist · NPI assigned 03/15/2012

$74K
Total Medicaid Paid
4,926
Total Claims
4,920
Beneficiaries
10
Codes Billed
2018-03
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSHAMTOUB, KOOROSH (PRESIDENT)
NPI Enumeration Date03/15/2012

Related Entities

Other providers sharing the same authorized official: SHAMTOUB, KOOROSH

ProviderCityStateTotal Paid
CAMBRIA DENTISTRY PLLC CAMBRIA HEIGHTS NY $1.51M
KOOROSH SHAMTOUB DDS PC BROOKLYN NY $675K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 314 $4K
2019 839 $12K
2020 536 $8K
2021 550 $9K
2022 286 $3K
2023 1,440 $23K
2024 961 $15K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 664 664 $22K
D0274 Bitewings - four radiographic images 883 882 $16K
D0220 Intraoral - periapical first radiographic image 1,193 1,192 $11K
D0150 Comprehensive oral evaluation - new or established patient 402 401 $8K
D0120 Periodic oral evaluation - established patient 307 307 $6K
D0230 Intraoral - periapical each additional radiographic image 1,122 1,121 $5K
D1120 Prophylaxis - child 97 96 $3K
D1208 Topical application of fluoride, excluding varnish 139 138 $2K
D0210 Intraoral - complete series of radiographic images 107 107 $567.47
D0272 Bitewings - two radiographic images 12 12 $148.85