EDINBURG DENTAL, PLLC
NPI: 1104364165
· SAN JUAN, TX 78589
· Pediatric Dentist
· NPI assigned 02/09/2017
$138K
Total Medicaid Paid
Provider Details
| Authorized Official | GUZMAN, SERGIO (PEDIATRIC DENTIST/OWNER) |
| NPI Enumeration Date | 02/09/2017 |
Related Entities
Other providers sharing the same authorized official: GUZMAN, SERGIO
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
136 |
$2K |
| 2021 |
1,805 |
$32K |
| 2022 |
3,266 |
$61K |
| 2023 |
1,848 |
$29K |
| 2024 |
1,008 |
$14K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0145 |
Oral evaluation for a patient under three years of age |
242 |
234 |
$32K |
| D1120 |
Prophylaxis - child |
702 |
659 |
$23K |
| D0120 |
Periodic oral evaluation - established patient |
739 |
690 |
$19K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,170 |
1,092 |
$15K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,440 |
937 |
$14K |
| D0220 |
Intraoral - periapical first radiographic image |
1,089 |
1,003 |
$12K |
| D0272 |
Bitewings - two radiographic images |
341 |
313 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
243 |
217 |
$7K |
| D1110 |
Prophylaxis - adult |
110 |
102 |
$5K |
| D0274 |
Bitewings - four radiographic images |
128 |
118 |
$3K |
| D0350 |
|
13 |
13 |
$202.18 |
| D0603 |
|
1,846 |
1,768 |
$0.00 |