Dental
Dirawi, Sam
Dirawi, Sam was paid $82K by Medicaid between Apr 2018 and Sep 2019, across 12 billing codes. Its largest line is D1110, Prophylaxis - adult — 39% of everything it billed.
33Billing provider infoDIRAWI, SAM
PENFIELD, NY 14526
PENFIELD, NY 14526
33aNPI1366863250assigned 12/19/2013
33bProvider typeGeneral Practice Dentistry
28Total paid$82K
24GClaims2,045
24DCodes billed12
24AFirst – last monthApr 2018 – Sep 2019
Compared with peers
Next to other General Practice Dentistry providers in New York
Rank by total paid#935 of 2,184
Median peer was paid$54K
This provider vs. median1.5×
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 | 813 | $32K | |
| 2019 | 1,232 | $50K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 39% | 475 | 475 | $32K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 17% | 421 | 421 | $14K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 9.9% | 82 | 55 | $8K |
| D0274 | Bitewings - four radiographic images | 7.9% | 193 | 193 | $6K |
| D0150 | Comprehensive oral evaluation - new or established patient | 5.5% | 134 | 134 | $5K |
| D0140 | Limited oral evaluation - problem focused | 5.4% | 249 | 249 | $4K |
| D0330 | Panoramic radiographic image | 5.4% | 99 | 99 | $4K |
| D0220 | Intraoral - periapical first radiographic image | 4.3% | 238 | 238 | $4K |
| D1120 | Dental cleaning, childProphylaxis - child | 2.1% | 35 | 35 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.8% | 23 | 16 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 1.6% | 81 | 81 | $1K |
| D0272 | Bitewings - two radiographic images | <1% | 15 | 15 | $306.42 |
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.