Dental
Rafael Rivera, JR., DDS, PLLC
Rafael Rivera, JR., DDS, PLLC was paid $22.17M by Medicaid between Jan 2018 and Dec 2024, across 44 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 13% of everything it billed.
33Billing provider infoRAFAEL RIVERA, JR., DDS, PLLC
WINSTON SALEM, NC 27103
WINSTON SALEM, NC 27103
33aNPI1740459650assigned 02/25/2008
33bProvider typeDentist
28Total paid$22.17M
24GClaims590,291
24DCodes billed44
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dentist providers in North Carolina
Rank by total paid#1 of 402
Median peer was paid$154K
This provider vs. median144×
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 | 96,555 | $3.27M | |
| 2019 | 90,703 | $3.38M | |
| 2020 | 67,917 | $2.75M | |
| 2021 | 85,180 | $3.62M | |
| 2022 | 86,148 | $3.13M | |
| 2023 | 83,897 | $3.21M | |
| 2024incomplete | 79,891 | $2.81M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 13% | 19,476 | 7,842 | $2.83M |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 10% | 87,318 | 85,524 | $2.28M |
| D1120 | Dental cleaning, childProphylaxis - child | 7.4% | 60,095 | 58,664 | $1.64M |
| D2140 | 6.7% | 20,905 | 12,234 | $1.49M | |
| D1110 | Prophylaxis - adult | 6.6% | 38,351 | 37,444 | $1.47M |
| D1206 | Topical application of fluoride varnish | 6.0% | 81,534 | 79,453 | $1.34M |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 5.9% | 16,096 | 5,244 | $1.32M |
| D2934 | 4.9% | 5,711 | 1,991 | $1.09M | |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 4.7% | 11,096 | 6,863 | $1.04M |
| D1351 | Sealant - per tooth | 4.1% | 32,782 | 8,443 | $905K |
| D0220 | Intraoral - periapical first radiographic image | 3.9% | 57,574 | 56,177 | $870K |
| D7140 | Extraction, erupted tooth or exposed root | 3.1% | 10,641 | 6,235 | $680K |
32 more codes
| D0274 | Bitewings - four radiographic images | 3.0% | 24,210 | $665K |
| D0330 | Panoramic radiographic image | 2.9% | 13,043 | $650K |
| D9243 | 2.5% | 4,002 | $546K | |
| D0272 | Bitewings - two radiographic images | 2.1% | 25,968 | $477K |
| D7230 | 1.6% | 2,189 | $362K | |
| D0230 | Intraoral - periapical each additional radiographic image | 1.6% | 28,847 | $348K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.5% | 7,816 | $342K |
| D1208 | Topical application of fluoride, excluding varnish | 1.1% | 15,561 | $245K |
| D7240 | Removal of impacted tooth - completely bony | 1.1% | 1,183 | $235K |
| D2160 | <1% | 1,907 | $211K | |
| D1510 | <1% | 810 | $156K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 1,508 | $148K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 3,254 | $148K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 1,696 | $132K |
| D0140 | Limited oral evaluation - problem focused | <1% | 3,421 | $128K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 3,924 | $86K |
| D9239 | <1% | 1,109 | $81K | |
| D7111 | <1% | 1,577 | $80K | |
| D3230 | <1% | 484 | $67K | |
| D9610 | <1% | 1,095 | $39K | |
| D9420 | <1% | 170 | $20K | |
| D2331 | <1% | 192 | $13K | |
| D2330 | <1% | 176 | $11K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 67 | $9K |
| D2332 | <1% | 53 | $3K | |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | <1% | 21 | $2K |
| D2335 | <1% | 14 | $2K | |
| D9440 | <1% | 14 | $893.94 | |
| D0999 | Unspecified diagnostic procedure, by report | <1% | 17 | $323.40 |
| D1354 | <1% | 36 | $254.01 | |
| D0350 | <1% | 4,068 | $234.00 | |
| D1999 | 0% | 280 | $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.
From NPPES
Who's on the registration
Authorized officialSHIROMA, MAUREEN (DIRECTOR OF OFFICE MANAGERS)
| Provider | Location | Paid |
|---|---|---|
| Rafael Rivera, JR., DDS, PLLC | Raleigh, NC | $19.23M |
| Rafael Rivera, JR., DDS, PLLC | Greensboro, NC | $17.81M |
| Rafael Rivera, JR., DDS, PLLC | Asheville, NC | $16.43M |
| Rafael Rivera, JR, DDS, PLLC | Charlotte, NC | $14.82M |
| Rafael Rivera, JR., DDS, PLLC | Fayetteville, NC | $14.29M |
| Rafael Rivera, JR., DDS, PLLC | Charlotte, NC | $13.98M |
| Rafael Rivera, JR, DDS, PLLC | Hickory, NC | $8.80M |
| Rafael Rivera, JR, DDS, PLLC | Wilmington, NC | $8.63M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.