UNIVERSITY OF THE PACIFIC
NPI: 1609428275
· SAN FRANCISCO, CA 94103
· Dentist
· NPI assigned 07/12/2019
$1.78M
Total Medicaid Paid
Provider Details
| Authorized Official | PEGUEROS, ED (ASST DEAN, BUDGET & FIN ADMIN, AO) |
| Parent Organization | UNIVERSITY OF THE PACIFIC ARTHUR A. DUGONI |
| NPI Enumeration Date | 07/12/2019 |
Related Entities
Other providers sharing the same authorized official: PEGUEROS, ED
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
2,909 |
$91K |
| 2020 |
4,218 |
$131K |
| 2021 |
8,521 |
$300K |
| 2022 |
6,403 |
$223K |
| 2023 |
6,799 |
$518K |
| 2024 |
6,028 |
$523K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9999 |
Unspecified adjunctive procedure, by report |
25,747 |
23,739 |
$642K |
| D2740 |
Crown - porcelain/ceramic |
1,315 |
1,110 |
$615K |
| D4341 |
|
3,028 |
1,530 |
$210K |
| D1110 |
Prophylaxis - adult |
1,362 |
1,362 |
$122K |
| D4910 |
|
813 |
810 |
$62K |
| D4342 |
|
1,293 |
669 |
$54K |
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
101 |
100 |
$47K |
| D1206 |
Topical application of fluoride varnish |
1,194 |
1,192 |
$21K |
| D5110 |
|
12 |
12 |
$8K |
| D3320 |
|
13 |
12 |
$4K |