NPI: 1699414508 · MAYAGUEZ, PR 00680 · General Practice Dentistry · NPI assigned 05/31/2022
| Authorized Official | RAMIREZ DE ARELLANO PONCE, UBALDINO (PRESIDENT) |
| NPI Enumeration Date | 05/31/2022 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 1,071 | $17K |
| 2024 | 4,032 | $66K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 827 | 501 | $25K |
| D1999 | 1,400 | 825 | $20K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 386 | 254 | $9K |
| D0272 | Bitewings - two radiographic images | 539 | 322 | $8K |
| D0230 | Intraoral - periapical each additional radiographic image | 860 | 394 | $7K |
| D0120 | Periodic oral evaluation - established patient | 407 | 217 | $6K |
| D0220 | Intraoral - periapical first radiographic image | 621 | 374 | $5K |
| D1208 | Topical application of fluoride, excluding varnish | 63 | 38 | $934.29 |