Dental
Licdentalandmedicalcsp
Licdentalandmedicalcsp was paid $52K by Medicaid between Mar 2018 and Dec 2024, across 10 billing codes. Its largest line is D1110, Prophylaxis - adult — 21% of everything it billed.
33Billing provider infoLICDENTALANDMEDICALCSP
CANOVANAS, PR 00729
CANOVANAS, PR 00729
33aNPI1164706297assigned 10/07/2011
33bProvider typeGeneral Practice Dentistry
28Total paid$52K
24GClaims2,931
24DCodes billed10
24AFirst – last monthMar 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Puerto Rico
Rank by total paid#341 of 551
Median peer was paid$99K
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 | 496 | $9K | |
| 2019 | 1,484 | $27K | |
| 2020 | 125 | $3K | |
| 2021 | 303 | $5K | |
| 2022 | 227 | $4K | |
| 2023 | 192 | $3K | |
| 2024incomplete | 104 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 21% | 412 | 369 | $11K |
| D0330 | Panoramic radiographic image | 17% | 322 | 261 | $9K |
| D0150 | Comprehensive oral evaluation - new or established patient | 13% | 428 | 361 | $7K |
| D0272 | Bitewings - two radiographic images | 13% | 475 | 412 | $7K |
| D1999 | 12% | 459 | 377 | $6K | |
| D1208 | Topical application of fluoride, excluding varnish | 8.5% | 317 | 254 | $4K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 6.6% | 243 | 209 | $3K |
| D1120 | Dental cleaning, childProphylaxis - child | 4.6% | 139 | 108 | $2K |
| D2140 | 2.5% | 61 | 28 | $1K | |
| D1351 | Sealant - per tooth | 2.0% | 75 | 12 | $1K |
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 officialITURRINO, LUIS (PRESIDENT)