Four Molar PSC

Four Molar PSC was paid $2.99M by Medicaid between Jan 2018 and Dec 2024, across 10 billing codes. Its largest line is D7240, Removal of impacted tooth - completely bony — 24% of everything it billed.

33Billing provider infoFOUR MOLAR PSC
GUAYNABO, PR 00969

33aNPI1164814042assigned 03/02/2015

33bProvider typeOral and Maxillofacial Surgery (Dentist)

28Total paid$2.99M

24GClaims29,553

24DCodes billed10

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Oral and Maxillofacial Surgery (Dentist) providers in Puerto Rico

Rank by total paid#4 of 38

Median peer was paid$66K

This provider vs. median45×

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	5,081	$367K
2019	3,983	$346K
2020	2,440	$197K
2021	4,298	$391K
2022	4,096	$411K
2023	3,909	$460K
2024incomplete	5,746	$816K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D7240	Removal of impacted tooth - completely bony	24%	4,050	1,612	$726K
D7230		23%	4,156	1,753	$674K
D9223	Deep sedation/general anesthesia - each subsequent 15 minute increment	21%	3,295	2,806	$624K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth	14%	5,188	2,906	$420K
D0160		9.2%	7,546	6,499	$275K
D7220		4.6%	929	597	$138K
D0330	Panoramic radiographic image	1.7%	1,646	1,479	$52K
D1999		1.1%	2,146	2,057	$33K
D7250		<1%	406	214	$27K
D9222		<1%	191	190	$19K

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 officialRAMIREZ DIAZ, RAFAEL (OWNER)