Medicaid Provider Spending

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

DELDENTAL GROUP

NPI: 1376715771 · PLAYA DEL REY, CA 90293 · General Practice Dentistry · NPI assigned 03/26/2008

$40K
Total Medicaid Paid
1,207
Total Claims
1,201
Beneficiaries
7
Codes Billed
2018-02
First Month
2024-11
Last Month

Provider Details

Authorized OfficialFATTAHI, SHAHRZAD (OWNER)
NPI Enumeration Date03/26/2008

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 76 $2K
2019 238 $6K
2020 53 $1K
2021 214 $6K
2022 196 $6K
2023 230 $10K
2024 200 $8K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 286 286 $16K
D1206 Topical application of fluoride varnish 567 561 $8K
D1120 Prophylaxis - child 118 118 $4K
D1110 Prophylaxis - adult 42 42 $4K
D0150 Comprehensive oral evaluation - new or established patient 54 54 $4K
D0274 Bitewings - four radiographic images 113 113 $2K
D0210 Intraoral - complete series of radiographic images 27 27 $1K