Clinic
Robert Bootehsaz DMD INC
Robert Bootehsaz DMD INC was paid $158K by Medicaid between Mar 2018 and Nov 2024, across 11 billing codes. Its largest line is D0120, dental checkup, returning patient — 27% of everything it billed.
33Billing provider infoROBERT BOOTEHSAZ DMD INC
TARZANA, CA 91356
TARZANA, CA 91356
33aNPI1689087199assigned 06/03/2014
33bProvider typeDental Clinic/Center
28Total paid$158K
24GClaims5,317
24DCodes billed11
24AFirst – last monthMar 2018 – Nov 2024
Compared with peers
Next to other Dental Clinic/Center providers in California
Rank by total paid#610 of 1,135
Median peer was paid$200K
This provider vs. median0.8×
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 | 143 | $3K | |
| 2019 | 387 | $12K | |
| 2020 | 781 | $15K | |
| 2021 | 814 | $16K | |
| 2022 | 954 | $26K | |
| 2023 | 1,353 | $49K | |
| 2024incomplete | 885 | $38K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 27% | 632 | 631 | $43K |
| D1110 | Prophylaxis - adult | 26% | 468 | 468 | $42K |
| D1208 | Topical application of fluoride, excluding varnish | 14% | 1,536 | 1,530 | $23K |
| D0230 | Intraoral - periapical each additional radiographic image | 7.5% | 1,698 | 576 | $12K |
| D4910 | 6.3% | 121 | 121 | $10K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 5.2% | 132 | 128 | $8K |
| D9430 | 4.7% | 238 | 199 | $7K | |
| D0274 | Bitewings - four radiographic images | 4.0% | 294 | 294 | $6K |
| D0210 | Intraoral - complete series of radiographic images | 2.7% | 93 | 90 | $4K |
| D1120 | Dental cleaning, childProphylaxis - child | 1.2% | 53 | 53 | $2K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 52 | 49 | $690.00 |
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.
From NPPES
Who's on the registration
Authorized officialBOOTEHSAZ, ROBERT (OWNER)