MOHAMAD IQBALL RAJABALLY
NPI: 1487831921
· NEWARK, CA 94560
· General Practice Dentistry
· NPI assigned 01/28/2008
$141K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,744 |
$39K |
| 2019 |
2,908 |
$55K |
| 2020 |
1,199 |
$21K |
| 2021 |
1,338 |
$20K |
| 2022 |
405 |
$7K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
485 |
480 |
$39K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
394 |
393 |
$25K |
| D0230 |
Intraoral - periapical each additional radiographic image |
5,021 |
1,104 |
$20K |
| D0120 |
Periodic oral evaluation - established patient |
543 |
539 |
$20K |
| D0274 |
Bitewings - four radiographic images |
734 |
730 |
$15K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,018 |
1,012 |
$12K |
| D1120 |
Prophylaxis - child |
260 |
258 |
$7K |
| D9430 |
|
53 |
53 |
$2K |
| D1351 |
Sealant - per tooth |
62 |
12 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$144.00 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$144.00 |