WEST AVENUE DENTAL PARTNERS PLLC
NPI: 1104285022
· SAN ANTONIO, TX 78213
· Dentist
· NPI assigned 02/19/2016
Provider Details
| Authorized Official | SOUSA, APRIL (DENTIST) |
| NPI Enumeration Date | 02/19/2016 |
Related Entities
Other providers sharing the same authorized official: SOUSA, APRIL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
178 |
$3K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
15 |
14 |
$686.68 |
| D0120 |
Periodic oral evaluation - established patient |
29 |
26 |
$655.00 |
| D0274 |
Bitewings - four radiographic images |
19 |
18 |
$521.93 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$404.25 |
| D0220 |
Intraoral - periapical first radiographic image |
20 |
19 |
$241.52 |
| D1206 |
Topical application of fluoride varnish |
16 |
16 |
$205.80 |
| D0230 |
Intraoral - periapical each additional radiographic image |
16 |
15 |
$171.63 |
| D0603 |
|
51 |
42 |
$0.00 |