Dental
Sagarduy, Lismary
Sagarduy, Lismary was paid $29K by Medicaid between Nov 2021 and Oct 2024, across 11 billing codes. Its largest line is D0330, Panoramic radiographic image — 44% of everything it billed.
33Billing provider infoSAGARDUY, LISMARY
MIAMI SPRINGS, FL 33166
MIAMI SPRINGS, FL 33166
33aNPI1497314744assigned 06/11/2019
33bProvider typeGeneral Practice Dentistry
28Total paid$29K
24GClaims1,528
24DCodes billed11
24AFirst – last monthNov 2021 – Oct 2024
Compared with peers
Next to other General Practice Dentistry providers in Florida
Rank by total paid#272 of 568
Median peer was paid$24K
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 | |
|---|---|---|---|
| 2021 | 25 | $695.05 | |
| 2022 | 1,258 | $26K | |
| 2023 | 176 | $3K | |
| 2024incomplete | 69 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0330 | Panoramic radiographic image | 44% | 276 | 271 | $13K |
| D1110 | Prophylaxis - adult | 17% | 222 | 215 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | 16% | 370 | 360 | $5K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 14% | 86 | 52 | $4K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 7.5% | 110 | 57 | $2K |
| D1120 | Dental cleaning, childProphylaxis - child | <1% | 14 | 14 | $199.00 |
| D0274 | Bitewings - four radiographic images | <1% | 322 | 317 | $85.26 |
| D0210 | Intraoral - complete series of radiographic images | <1% | 32 | 31 | $48.00 |
| D1330 | <1% | 40 | 40 | $20.95 | |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 43 | 43 | $15.26 |
| D0220 | Intraoral - periapical first radiographic image | 0% | 13 | 13 | $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.