Clinic
Rafael Pou DDS INC
Rafael Pou DDS INC was paid $47K by Medicaid between Aug 2021 and Oct 2024, across 8 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 34% of everything it billed.
33Billing provider infoRAFAEL POU DDS INC
MAYWOOD, CA 90270
MAYWOOD, CA 90270
33aNPI1134614134assigned 06/22/2018
33bProvider typeDental Clinic/Center
28Total paid$47K
24GClaims1,567
24DCodes billed8
24AFirst – last monthAug 2021 – Oct 2024
Compared with peers
Next to other Dental Clinic/Center providers in California
Rank by total paid#802 of 1,135
Median peer was paid$200K
This provider vs. median0.2×
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 | |
|---|---|---|---|
| 2021 | 175 | $5K | |
| 2022 | 16 | $990.00 | |
| 2023 | 124 | $5K | |
| 2024incomplete | 1,252 | $36K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 34% | 243 | 243 | $16K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 22% | 155 | 72 | $10K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 17% | 145 | 58 | $8K |
| D0350 | 11% | 571 | 136 | $5K | |
| D0210 | Intraoral - complete series of radiographic images | 6.9% | 67 | 67 | $3K |
| D1208 | Topical application of fluoride, excluding varnish | 4.7% | 163 | 163 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.4% | 198 | 75 | $2K |
| D0274 | Bitewings - four radiographic images | 1.0% | 25 | 25 | $480.60 |
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.
From NPPES
Who's on the registration
Authorized officialPOU, RAFAEL (DENTIST)