NPI: 1740913268 · TOA ALTA, PR 00953 · Public Health Dentist · NPI assigned 07/01/2022
| Authorized Official | SANCHEZ QUINONES, JESSICA (PRESIDENT) |
| NPI Enumeration Date | 07/01/2022 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 430 | $9K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 86 | 86 | $3K |
| D1999 | 139 | 136 | $2K | |
| D0120 | Periodic oral evaluation - established patient | 77 | 77 | $1K |
| D0272 | Bitewings - two radiographic images | 75 | 75 | $1K |
| D0330 | Panoramic radiographic image | 17 | 17 | $640.00 |
| D1208 | Topical application of fluoride, excluding varnish | 24 | 24 | $355.92 |
| D0150 | Comprehensive oral evaluation - new or established patient | 12 | 12 | $275.00 |