Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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CONCILIO DE SALUD INTEGRAL DE LOIZA

NPI: 1073808176 · LOIZA, PR 00772 · Dentist · NPI assigned 06/16/2011

$5K
Total Medicaid Paid
474
Total Claims
467
Beneficiaries
5
Codes Billed
2018-11
First Month
2019-10
Last Month

Provider Details

Authorized OfficialRODRIGUEZ ROMAN, CESAR (DIRECTOR EJECUTIVO)
NPI Enumeration Date06/16/2011

Related Entities

Other providers sharing the same authorized official: RODRIGUEZ ROMAN, CESAR

ProviderCityStateTotal Paid
CONCILIO DE SALUD INTEGRAL DE LOIZA INC LOIZA PR $502K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 79 $1K
2019 395 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 132 132 $2K
D0120 Periodic oral evaluation - established patient 228 222 $2K
D0272 Bitewings - two radiographic images 80 79 $645.00
D1120 Prophylaxis - child 17 17 $272.00
D1208 Topical application of fluoride, excluding varnish 17 17 $238.00