Salud en tus manos

Comunicación Importante

Gobierno de Puerto Rico, Administradora de Seguros de Salud.

Administración de Seguros de Salud
Minimum Suggested Reimbursement Rates for Dental Procedures

Procedure 

Procedure Family 

Minimum Fee 

D0120 

I-Oral Evaluations 

$14.28

D0140 

I-Oral Evaluations 

$19.17

D0150 

I-Oral Evaluations 

$22.58

D0160 

I-Oral Evaluations 

$35.65

D0210 

I-X-Rays 

$44.76

D0220 

I-X-Rays 

$7.57

D0230 

I-X-Rays 

$7.60

D0270 

I-X-Rays 

$7.56

D0272 

I-X-Rays 

$13.35

D0330 

I-X-Rays 

$27.51

D1110 

I-Prophylaxis 

$25.85

D1120 

I-Prophylaxis 

$18.40

D1206 

I-Fluoride 

$13.58

D1208 

I-Fluoride 

$13.58

D1351 

I-Sealants 

$14.88

D2140 

II-Restorations 

$34.67

D2150 

II-Restorations 

$42.68

D2160 

II-Restorations 

$50.92

D2161 

II-Restorations 

$60.10

D2330 

II-Restorations 

$39.93

D2331 

II-Restorations 

$49.07

D2332 

II-Restorations 

$58.81

D2335 

II-Restorations 

$70.38

D2391 

II-Restorations 

$43.74

D2930 

III-Inlays/Onlays/Crowns 

$58.33

D3120 

II-Endodontics 

$18.80

D3220 

II-Endodontics 

$48.85

D3221 

II-Endodontics 

$24.15

D3310 

II-Endodontics 

$136.90

D3320 

II-Endodontics 

$149.53

D7140 

II-Simple Extractions 

$39.28

D7210 

II-Surgical Extractions 

$70.10

D7220 

II-Surgical Extractions 

$112.15

D7230 

II-Surgical Extractions 

$138.25

D7240 

II-Surgical Extractions 

$159.81

D7250 

II-Surgical Extractions 

$49.76

D7510 

II-Oral Surgery 

$22.41

D9110 

II-Emergency (Palliative) 

$23.90

D9420 

Other 

$206.43

D9930 

Other 

$18.42

D9223 

II-Anesthesia 

$173.95