Amaya Gutierrez, Tarcisio

Amaya Gutierrez, Tarcisio was paid $11K by Medicaid between Jul 2021 and Dec 2021, across 8 billing codes. Its largest line is D0120, dental checkup, returning patient — 40% of everything it billed.

33Billing provider infoAMAYA GUTIERREZ, TARCISIO
WASHINGTON, DC 20009

33aNPI1235782095assigned 07/22/2019

33bProvider typeGeneral Practice Dentistry

28Total paid$11K

24GClaims547

24DCodes billed8

24AFirst – last monthJul 2021 – Dec 2021

Compared with peers

Next to other General Practice Dentistry providers in District of Columbia

Rank by total paid#64 of 93

Median peer was paid$36K

This provider vs. median0.3×

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	547	$11K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	40%	187	153	$4K
D1120	Dental cleaning, childProphylaxis - child	19%	68	50	$2K
D1208	Topical application of fluoride, excluding varnish	18%	115	91	$2K
D0274	Bitewings - four radiographic images	16%	59	48	$2K
D1110	Prophylaxis - adult	6.1%	12	12	$656.07
D0220	Intraoral - periapical first radiographic image	1.6%	13	13	$172.14
D2999		0%	21	19	$0.00
D0999	Unspecified diagnostic procedure, by report	0%	72	68	$0.00

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.