JRRDMD PSC
NPI: 1013417690
· CAMUY, PR 00627
· General Practice Dentistry
· NPI assigned 02/20/2018
$169K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
727 |
$12K |
| 2020 |
988 |
$20K |
| 2021 |
1,085 |
$20K |
| 2022 |
1,814 |
$34K |
| 2023 |
1,344 |
$26K |
| 2024 |
2,842 |
$58K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,746 |
1,439 |
$53K |
| D1999 |
|
2,888 |
2,440 |
$43K |
| D0120 |
Periodic oral evaluation - established patient |
1,418 |
1,155 |
$22K |
| D0272 |
Bitewings - two radiographic images |
1,258 |
1,020 |
$18K |
| D0330 |
Panoramic radiographic image |
409 |
320 |
$12K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
446 |
376 |
$10K |
| D1208 |
Topical application of fluoride, excluding varnish |
478 |
362 |
$7K |
| D1120 |
Prophylaxis - child |
157 |
120 |
$3K |