M. SALEH KHOLAKI D.D.S, INC.
NPI: 1568834232
· MONROVIA, CA 91016
· Dentist
· NPI assigned 10/21/2015
$750.00
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
12 |
$420.00 |
| 2020 |
12 |
$330.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$420.00 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$330.00 |