Clinic
San Juan Pediatric Dental Home PSC
San Juan Pediatric Dental Home PSC was paid $180K by Medicaid between Jan 2018 and Dec 2024, across 8 billing codes. Its largest line is D1208, Topical application of fluoride, excluding varnish — 22% of everything it billed.
33Billing provider infoSAN JUAN PEDIATRIC DENTAL HOME PSC
SAN JUAN, PR 00927
SAN JUAN, PR 00927
33aNPI1780876995assigned 08/11/2007
33bProvider typeDental Clinic/Center
28Total paid$180K
24GClaims11,406
24DCodes billed8
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Puerto Rico
Rank by total paid#30 of 81
Median peer was paid$94K
This provider vs. median1.9×
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 | 2,166 | $29K | |
| 2019 | 2,291 | $35K | |
| 2020 | 1,904 | $37K | |
| 2021 | 1,780 | $28K | |
| 2022 | 1,694 | $27K | |
| 2023 | 625 | $9K | |
| 2024incomplete | 946 | $15K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1208 | Topical application of fluoride, excluding varnish | 22% | 2,898 | 2,419 | $39K |
| D1120 | Dental cleaning, childProphylaxis - child | 20% | 2,091 | 1,787 | $36K |
| D1999 | 18% | 2,000 | 1,790 | $33K | |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 15% | 2,063 | 1,777 | $27K |
| D7140 | Extraction, erupted tooth or exposed root | 10% | 702 | 245 | $18K |
| D0150 | Comprehensive oral evaluation - new or established patient | 5.8% | 619 | 511 | $11K |
| D0272 | Bitewings - two radiographic images | 5.8% | 774 | 688 | $10K |
| D1110 | Prophylaxis - adult | 3.3% | 259 | 209 | $6K |
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 officialAYMAT, NOEL (PRESIDENT AND PEDIATRIC DENTIST)
| Provider | Location | Paid |
|---|---|---|
| University of Puerto Rico MSC | San Juan, PR | $43K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.