RIVERA, YILDA
NPI: 1053309815
· HATO REY, PR 00918
· Pediatric Dentist
· NPI assigned 10/06/2005
$698.40
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
54 |
$698.40 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1208 |
Topical application of fluoride, excluding varnish |
21 |
21 |
$283.50 |
| D1120 |
Prophylaxis - child |
14 |
14 |
$226.80 |
| D0120 |
Periodic oral evaluation - established patient |
19 |
19 |
$188.10 |