SIMON MASOOD IMANUEL DMD,INC.
NPI: 1598835225
· SYLMAR, CA 91342
· Dentist
· NPI assigned 11/09/2006
$439K
Total Medicaid Paid
Provider Details
| Authorized Official | IMANUEL, SIMON (PRESIDENT) |
| NPI Enumeration Date | 11/09/2006 |
Related Entities
Other providers sharing the same authorized official: IMANUEL, SIMON
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
4,133 |
$57K |
| 2019 |
3,901 |
$73K |
| 2020 |
1,964 |
$52K |
| 2021 |
2,291 |
$61K |
| 2022 |
2,101 |
$70K |
| 2023 |
2,092 |
$68K |
| 2024 |
1,572 |
$58K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,961 |
1,945 |
$102K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,526 |
1,514 |
$95K |
| D1120 |
Prophylaxis - child |
1,624 |
1,611 |
$59K |
| D0230 |
Intraoral - periapical each additional radiographic image |
7,050 |
2,466 |
$49K |
| D0210 |
Intraoral - complete series of radiographic images |
986 |
975 |
$45K |
| D0274 |
Bitewings - four radiographic images |
1,939 |
1,928 |
$37K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,003 |
1,986 |
$23K |
| D1351 |
Sealant - per tooth |
378 |
94 |
$10K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
74 |
48 |
$5K |
| D4341 |
|
48 |
13 |
$3K |
| D1110 |
Prophylaxis - adult |
34 |
34 |
$3K |
| D0350 |
|
211 |
164 |
$3K |
| D9430 |
|
84 |
81 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
98 |
96 |
$1K |
| D0272 |
Bitewings - two radiographic images |
26 |
26 |
$276.00 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$227.00 |