Clinic
Dental Gallery PSC
Dental Gallery PSC was paid $113K by Medicaid between Jan 2018 and Nov 2024, across 8 billing codes. Its largest line is D1110, Prophylaxis - adult — 34% of everything it billed.
33Billing provider infoDENTAL GALLERY PSC
SAN JUAN, PR 00927
SAN JUAN, PR 00927
33aNPI1295139707assigned 10/13/2014
33bProvider typeDental Clinic/Center
28Total paid$113K
24GClaims5,064
24DCodes billed8
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Dental Clinic/Center providers in Puerto Rico
Rank by total paid#39 of 81
Median peer was paid$94K
This provider vs. median1.2×
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 | |
|---|---|---|---|
| 2018 | 726 | $15K | |
| 2019 | 295 | $6K | |
| 2020 | 753 | $20K | |
| 2021 | 1,357 | $31K | |
| 2022 | 1,065 | $24K | |
| 2023 | 464 | $9K | |
| 2024incomplete | 404 | $8K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 34% | 1,428 | 1,289 | $38K |
| D1999 | 25% | 1,840 | 1,515 | $29K | |
| D0210 | Intraoral - complete series of radiographic images | 20% | 530 | 519 | $23K |
| D0150 | Comprehensive oral evaluation - new or established patient | 16% | 871 | 826 | $18K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 3.1% | 257 | 247 | $4K |
| D1208 | Topical application of fluoride, excluding varnish | 1.4% | 111 | 110 | $2K |
| D1120 | Dental cleaning, childProphylaxis - child | <1% | 15 | 15 | $315.00 |
| D0272 | Bitewings - two radiographic images | <1% | 12 | 12 | $155.25 |
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 officialRIVERA, ELISA (DENTIST)
| Provider | Location | Paid |
|---|---|---|
| Bairoa Dental Care | San Juan, PR | $362.75 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.