NPI: 1740330802 · SAN LORENZO, PR 00754 · General Practice Dentistry · NPI assigned 01/11/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $270.50 |
| 2019 | 119 | $2K |
| 2020 | 66 | $1K |
| 2021 | 153 | $3K |
| 2022 | 173 | $3K |
| 2023 | 123 | $2K |
| 2024 | 28 | $406.28 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1999 | 385 | 343 | $6K | |
| D1110 | Prophylaxis - adult | 150 | 147 | $4K |
| D0272 | Bitewings - two radiographic images | 61 | 60 | $885.87 |
| D0120 | Periodic oral evaluation - established patient | 40 | 40 | $603.12 |
| D0210 | Intraoral - complete series of radiographic images | 12 | 12 | $597.12 |
| D0150 | Comprehensive oral evaluation - new or established patient | 26 | 25 | $376.56 |