AQUA INGRAM PLLC
NPI: 1942584040
· SAN ANTONIO, TX 78238
· Pediatric Dentist
· NPI assigned 10/06/2011
$4.98M
Total Medicaid Paid
Provider Details
| Authorized Official | RIVERA, ANTONIO (MANAGING MEMBER) |
| NPI Enumeration Date | 10/06/2011 |
Related Entities
Other providers sharing the same authorized official: RIVERA, ANTONIO
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
123 |
$2K |
| 2019 |
40 |
$0.00 |
| 2020 |
4,154 |
$107K |
| 2021 |
48,582 |
$1.30M |
| 2022 |
47,663 |
$1.36M |
| 2023 |
47,346 |
$1.25M |
| 2024 |
36,637 |
$963K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2392 |
|
11,994 |
6,574 |
$1.17M |
| D0120 |
|
19,278 |
19,055 |
$544K |
| D2391 |
|
6,333 |
3,799 |
$488K |
| D1120 |
|
13,314 |
13,168 |
$476K |
| D0230 |
|
35,307 |
16,001 |
$393K |
| D0145 |
|
2,097 |
2,078 |
$292K |
| D1208 |
|
19,875 |
19,646 |
$285K |
| D9230 |
|
10,615 |
10,422 |
$275K |
| D1351 |
|
9,128 |
2,937 |
$243K |
| D1110 |
|
4,457 |
4,405 |
$239K |
| D0220 |
|
17,143 |
16,921 |
$209K |
| D0210 |
|
2,100 |
2,078 |
$136K |
| D0272 |
|
5,153 |
5,093 |
$118K |
| D0274 |
|
3,132 |
3,091 |
$106K |
| D2393 |
|
33 |
26 |
$3K |
| D2930 |
|
17 |
12 |
$3K |
| D0140 |
|
105 |
103 |
$2K |
| D2330 |
|
18 |
12 |
$1K |
| D0150 |
|
14 |
14 |
$494.48 |
| D0603 |
|
24,432 |
24,205 |
$0.00 |