ANTEZANA, MAURICIO
NPI: 1063876399
· ATLANTIS, FL 33462
· Student in an Organized Health Care Education/Training Program
· NPI assigned 04/12/2016
$964.87
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
33 |
$964.87 |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D0210 |
Intraoral - complete series of radiographic images |
17 |
17 |
$964.87 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
16 |
16 |
$0.00 |