Dental
Roya Nematollahi D.D.S. INC
Roya Nematollahi D.D.S. INC was paid $27K by Medicaid between Jan 2018 and Oct 2024, across 8 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 46% of everything it billed.
33Billing provider infoROYA NEMATOLLAHI D.D.S. INC
TUSTIN, CA 92780
TUSTIN, CA 92780
33aNPI1326462730assigned 02/06/2014
33bProvider typeGeneral Practice Dentistry
28Total paid$27K
24GClaims685
24DCodes billed8
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other General Practice Dentistry providers in California
Rank by total paid#1,964 of 2,668
Median peer was paid$173K
This provider vs. median0.2×
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 | 214 | $7K | |
| 2019 | 39 | $1K | |
| 2021 | 104 | $5K | |
| 2022 | 49 | $1K | |
| 2023 | 123 | $6K | |
| 2024incomplete | 156 | $7K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 46% | 223 | 220 | $12K |
| D0210 | Intraoral - complete series of radiographic images | 27% | 172 | 165 | $7K |
| D1206 | Topical application of fluoride varnish | 8.9% | 157 | 157 | $2K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 5.8% | 23 | 14 | $2K |
| D1110 | Prophylaxis - adult | 4.1% | 13 | 13 | $1K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 3.3% | 12 | 12 | $880.00 |
| D1120 | Dental cleaning, childProphylaxis - child | 2.8% | 28 | 27 | $750.00 |
| D1208 | Topical application of fluoride, excluding varnish | 2.0% | 57 | 56 | $522.00 |
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 officialNEMATOLLAHI, ROYA (DENTIST/OWNER)