Dental
Samudio, Javier
Samudio, Javier was paid $389K by Medicaid between Jan 2018 and Dec 2024, across 12 billing codes. Its largest line is D1110, Prophylaxis - adult — 24% of everything it billed.
33Billing provider infoSAMUDIO, JAVIER
FAR ROCKAWAY, NY 11691
FAR ROCKAWAY, NY 11691
33aNPI1679534895assigned 03/29/2006
33bProvider typeDentist
28Total paid$389K
24GClaims19,460
24DCodes billed12
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dentist providers in New York
Rank by total paid#270 of 1,649
Median peer was paid$49K
This provider vs. median7.9×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 2,198 | $32K | |
| 2019 | 2,566 | $40K | |
| 2020 | 2,378 | $50K | |
| 2021 | 3,428 | $81K | |
| 2022 | 3,002 | $62K | |
| 2023 | 3,056 | $65K | |
| 2024incomplete | 2,832 | $60K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 24% | 2,790 | 2,790 | $94K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 22% | 4,343 | 4,343 | $84K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 14% | 1,427 | 771 | $54K |
| D0210 | Intraoral - complete series of radiographic images | 11% | 1,197 | 1,197 | $42K |
| D0274 | Bitewings - four radiographic images | 9.5% | 2,173 | 2,173 | $37K |
| D0220 | Intraoral - periapical first radiographic image | 5.8% | 2,572 | 2,570 | $22K |
| D1120 | Dental cleaning, childProphylaxis - child | 5.4% | 735 | 735 | $21K |
| D1208 | Topical application of fluoride, excluding varnish | 4.9% | 1,795 | 1,795 | $19K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.8% | 2,335 | 2,335 | $11K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 66 | 51 | $4K |
| D9110 | <1% | 13 | 12 | $155.22 | |
| D0330 | Panoramic radiographic image | <1% | 14 | 14 | $141.62 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.