Dental
Great Smiles LLC
Great Smiles LLC was paid $9K by Medicaid between Oct 2024 and Dec 2024, across 7 billing codes. Its largest line is D1110, Prophylaxis - adult — 37% of everything it billed.
33Billing provider infoGREAT SMILES LLC
TOA ALTA, PR 00953
TOA ALTA, PR 00953
33aNPI1740913268assigned 07/01/2022
33bProvider typePublic Health Dentist
28Total paid$9K
24GClaims430
24DCodes billed7
24AFirst – last monthOct 2024 – Dec 2024
Compared with peers
Next to other Public Health Dentist providers in Puerto Rico
Rank by total paid#6 of 6
Median peer was paid$82K
This provider vs. median0.1×
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 | |
|---|---|---|---|
| 2024incomplete | 430 | $9K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 37% | 86 | 86 | $3K |
| D1999 | 22% | 139 | 136 | $2K | |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 14% | 77 | 77 | $1K |
| D0272 | Bitewings - two radiographic images | 14% | 75 | 75 | $1K |
| D0330 | Panoramic radiographic image | 7.1% | 17 | 17 | $640.00 |
| D1208 | Topical application of fluoride, excluding varnish | 3.9% | 24 | 24 | $355.92 |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.0% | 12 | 12 | $275.00 |
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 officialSANCHEZ QUINONES, JESSICA (PRESIDENT)