Dental
Aqua Ingram PLLC
Aqua Ingram PLLC was paid $4.98M by Medicaid between Mar 2018 and Dec 2024, across 20 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 23% of everything it billed.
33Billing provider infoAQUA INGRAM PLLC
SAN ANTONIO, TX 78238
SAN ANTONIO, TX 78238
33aNPI1942584040assigned 10/06/2011
33bProvider typePediatric Dentist
28Total paid$4.98M
24GClaims184,545
24DCodes billed20
24AFirst – last monthMar 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Texas
Rank by total paid#28 of 693
Median peer was paid$252K
This provider vs. median20×
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 | 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 | |
| 2024incomplete | 36,637 | $963K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 23% | 11,994 | 6,574 | $1.17M |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 19,278 | 19,055 | $544K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 9.8% | 6,333 | 3,799 | $488K |
| D1120 | Dental cleaning, childProphylaxis - child | 9.6% | 13,314 | 13,168 | $476K |
| D0230 | Intraoral - periapical each additional radiographic image | 7.9% | 35,307 | 16,001 | $393K |
| D0145 | Oral evaluation for a patient under three years of age | 5.9% | 2,097 | 2,078 | $292K |
| D1208 | Topical application of fluoride, excluding varnish | 5.7% | 19,875 | 19,646 | $285K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 5.5% | 10,615 | 10,422 | $275K |
| D1351 | Sealant - per tooth | 4.9% | 9,128 | 2,937 | $243K |
| D1110 | Prophylaxis - adult | 4.8% | 4,457 | 4,405 | $239K |
| D0220 | Intraoral - periapical first radiographic image | 4.2% | 17,143 | 16,921 | $209K |
| D0210 | Intraoral - complete series of radiographic images | 2.7% | 2,100 | 2,078 | $136K |
8 more codes
| D0272 | Bitewings - two radiographic images | 2.4% | 5,153 | $118K |
| D0274 | Bitewings - four radiographic images | 2.1% | 3,132 | $106K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 33 | $3K |
| D2930 | Prefabricated stainless steel crown - primary tooth | <1% | 17 | $3K |
| D0140 | Limited oral evaluation - problem focused | <1% | 105 | $2K |
| D2330 | <1% | 18 | $1K | |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 14 | $494.48 |
| D0603 | 0% | 24,432 | $0.00 |
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 officialRIVERA, ANTONIO (MANAGING MEMBER)
| Provider | Location | Paid |
|---|---|---|
| Arivera PLLC | Dallas, TX | $5.19M |
| A Rivera Medical Services LLC | Falls Church, VA | $193K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.