NPI: 1073740478 · TYLER, TX 75703 · General Practice Dentistry · NPI assigned 06/12/2009
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 20 | $0.00 |
| 2021 | 333 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0210 | Intraoral - complete series of radiographic images | 18 | 17 | $996.19 |
| D1110 | Prophylaxis - adult | 20 | 19 | $868.28 |
| D1208 | Topical application of fluoride, excluding varnish | 72 | 70 | $856.30 |
| D0150 | Comprehensive oral evaluation - new or established patient | 20 | 19 | $496.88 |
| D0120 | Periodic oral evaluation - established patient | 15 | 15 | $392.50 |
| D0230 | Intraoral - periapical each additional radiographic image | 40 | 12 | $284.69 |
| D0220 | Intraoral - periapical first radiographic image | 29 | 28 | $246.16 |
| D0603 | 48 | 48 | $0.01 | |
| D0602 | 25 | 25 | $0.00 | |
| D1999 | 66 | 58 | $0.00 |