Dental
Roustum, Hala
Roustum, Hala was paid $109K by Medicaid between Jan 2018 and Oct 2024, across 7 billing codes. Its largest line is D1110, Prophylaxis - adult — 59% of everything it billed.
33Billing provider infoROUSTUM, HALA
AMHERST, NY 14228
AMHERST, NY 14228
33aNPI1356436091assigned 10/04/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$109K
24GClaims2,943
24DCodes billed7
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other General Practice Dentistry providers in New York
Rank by total paid#835 of 2,184
Median peer was paid$54K
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 | 64 | $3K | |
| 2019 | 166 | $6K | |
| 2020 | 307 | $11K | |
| 2021 | 553 | $22K | |
| 2022 | 725 | $27K | |
| 2023 | 716 | $26K | |
| 2024incomplete | 412 | $15K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 59% | 1,240 | 1,239 | $65K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 28% | 1,163 | 1,161 | $31K |
| D0274 | Bitewings - four radiographic images | 6.0% | 253 | 253 | $7K |
| D0330 | Panoramic radiographic image | 3.7% | 108 | 108 | $4K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.9% | 71 | 71 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 74 | 74 | $1K |
| D1999 | 0% | 34 | 33 | $0.00 |
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.