Dental
Rustom, Sarah
Rustom, Sarah was paid $754.28 by Medicaid between Feb 2024 and Feb 2024, across 4 billing codes. Its largest line is D0120, dental checkup, returning patient — 42% of everything it billed.
33Billing provider infoRUSTOM, SARAH
MARRERO, LA 70072
MARRERO, LA 70072
33aNPI1912640699assigned 04/19/2022
33bProvider typeGeneral Practice Dentistry
28Total paid$754.28
24GClaims166
24DCodes billed4
24AFirst – last monthFeb 2024 – Feb 2024
Compared with peers
Next to other General Practice Dentistry providers in Louisiana
Rank by total paid#376 of 412
Median peer was paid$83K
This provider vs. median0.0×
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 | |
|---|---|---|---|
| 2024incomplete | 166 | $754.28 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 42% | 32 | 15 | $317.35 |
| D1208 | Topical application of fluoride, excluding varnish | 21% | 40 | 19 | $161.70 |
| D0230 | Intraoral - periapical each additional radiographic image | 20% | 56 | 16 | $149.63 |
| D0220 | Intraoral - periapical first radiographic image | 17% | 38 | 17 | $125.60 |
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.