MOCA DENTAL SERVICE PSC
NPI: 1790827624
· MOCA, PR 00676
· 1223G0001X
$976.36
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
84 |
$976.36 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
|
17 |
17 |
$428.85 |
| D0330 |
|
15 |
15 |
$352.51 |
| D0272 |
|
13 |
13 |
$195.00 |
| D1999 |
|
39 |
30 |
$0.00 |