Polhamus Lopez, Melisa

Polhamus Lopez, Melisa was paid $8K by Medicaid between Jun 2019 and Jul 2021, across 9 billing codes. Its largest line is D1110, Prophylaxis - adult — 33% of everything it billed.

33Billing provider infoPOLHAMUS LOPEZ, MELISA
CIDRA, PR 00739

33aNPI1942487905assigned 01/22/2008

33bProvider typeGeneral Practice Dentistry

28Total paid$8K

24GClaims600

24DCodes billed9

24AFirst – last monthJun 2019 – Jul 2021

Compared with peers

Next to other General Practice Dentistry providers in Puerto Rico

Rank by total paid#461 of 551

Median peer was paid$99K

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
2019	26	$445.24
2021	574	$7K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	33%	109	108	$2K
D1999		28%	226	218	$2K
D0272	Bitewings - two radiographic images	12%	74	72	$905.27
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	10%	70	69	$775.20
D0150	Comprehensive oral evaluation - new or established patient	6.1%	31	30	$463.79
D0330	Panoramic radiographic image	4.4%	14	14	$334.23
D0220	Intraoral - periapical first radiographic image	2.8%	41	40	$214.77
D1208	Topical application of fluoride, excluding varnish	2.5%	16	15	$186.36
D0230	Intraoral - periapical each additional radiographic image	1.4%	19	17	$104.16

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.