MARTINEZ, GUSTAVO
NPI: 1891832028
· MANATI, PR 00674
· General Practice Dentistry
· NPI assigned 01/30/2007
$165K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,921 |
$32K |
| 2019 |
2,296 |
$40K |
| 2020 |
897 |
$19K |
| 2021 |
840 |
$19K |
| 2022 |
988 |
$24K |
| 2023 |
433 |
$10K |
| 2024 |
833 |
$21K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
2,932 |
2,497 |
$78K |
| D0120 |
Periodic oral evaluation - established patient |
3,472 |
2,954 |
$45K |
| D7140 |
Extraction, erupted tooth or exposed root |
993 |
661 |
$30K |
| D1208 |
Topical application of fluoride, excluding varnish |
575 |
475 |
$8K |
| D1120 |
Prophylaxis - child |
194 |
162 |
$3K |
| D2140 |
|
42 |
30 |
$898.70 |