DE LA GARZA, JAVIER
NPI: 1114240363
· WESLACO, TX 78596
· General Practice Dentistry
· NPI assigned 03/02/2010
$718.75
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
46 |
$718.75 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
17 |
14 |
$395.35 |
| D1208 |
Topical application of fluoride, excluding varnish |
29 |
25 |
$323.40 |