WEST LOS ANGELES DENTISTRY
NPI: 1508923707
· LOS ANGELES, CA 90025
· Dental Clinic/Center
· NPI assigned 01/03/2007
$220K
Total Medicaid Paid
Provider Details
| Authorized Official | HAZANY, ROBERT (DENTIST PARTNER) |
| NPI Enumeration Date | 01/03/2007 |
Related Entities
Other providers sharing the same authorized official: HAZANY, ROBERT
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,225 |
$28K |
| 2019 |
1,699 |
$24K |
| 2020 |
1,341 |
$29K |
| 2021 |
1,584 |
$31K |
| 2022 |
320 |
$10K |
| 2023 |
1,124 |
$30K |
| 2024 |
2,181 |
$68K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,060 |
1,055 |
$68K |
| D0120 |
Periodic oral evaluation - established patient |
681 |
678 |
$34K |
| D1110 |
Prophylaxis - adult |
268 |
266 |
$23K |
| D0230 |
Intraoral - periapical each additional radiographic image |
4,288 |
1,496 |
$18K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,006 |
1,002 |
$14K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
183 |
81 |
$12K |
| D0350 |
|
1,268 |
517 |
$11K |
| D1120 |
Prophylaxis - child |
293 |
291 |
$11K |
| D0210 |
Intraoral - complete series of radiographic images |
205 |
205 |
$10K |
| D0220 |
Intraoral - periapical first radiographic image |
558 |
548 |
$7K |
| D0272 |
Bitewings - two radiographic images |
483 |
481 |
$6K |
| D4910 |
|
52 |
50 |
$4K |
| D9430 |
|
79 |
79 |
$2K |
| D9110 |
|
13 |
12 |
$756.00 |
| D1999 |
|
37 |
35 |
$70.00 |