Dental
Boostanfar, Sima
Boostanfar, Sima was paid $93K by Medicaid between Jan 2018 and Dec 2024, across 9 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 38% of everything it billed.
33Billing provider infoBOOSTANFAR, SIMA
ARLETA, CA 91331
ARLETA, CA 91331
33aNPI1982750741assigned 01/26/2007
33bProvider typeGeneral Practice Dentistry
28Total paid$93K
24GClaims3,523
24DCodes billed9
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in California
Rank by total paid#1,587 of 2,668
Median peer was paid$173K
This provider vs. median0.5×
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 | 717 | $15K | |
| 2019 | 476 | $9K | |
| 2020 | 61 | $2K | |
| 2022 | 506 | $14K | |
| 2023 | 477 | $11K | |
| 2024incomplete | 1,286 | $41K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 38% | 864 | 845 | $35K |
| D1110 | Prophylaxis - adult | 23% | 386 | 383 | $22K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 346 | 342 | $11K |
| D0230 | Intraoral - periapical each additional radiographic image | 10% | 651 | 612 | $9K |
| D0220 | Intraoral - periapical first radiographic image | 5.6% | 797 | 779 | $5K |
| D1208 | Topical application of fluoride, excluding varnish | 5.1% | 302 | 301 | $5K |
| D1120 | Dental cleaning, childProphylaxis - child | 3.9% | 129 | 128 | $4K |
| D9999 | Unspecified adjunctive procedure, by report | 1.6% | 12 | 12 | $2K |
| D1206 | Topical application of fluoride varnish | <1% | 36 | 36 | $402.00 |
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.