NPI: 1144728379 · EAGLE PASS, TX 78852 · General Practice Dentistry · NPI assigned 01/23/2018
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 139 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 14 | 14 | $514.50 |
| D0120 | Periodic oral evaluation - established patient | 17 | 17 | $490.45 |
| D0274 | Bitewings - four radiographic images | 12 | 12 | $380.71 |
| D1206 | Topical application of fluoride varnish | 19 | 19 | $279.30 |
| D0220 | Intraoral - periapical first radiographic image | 22 | 22 | $270.62 |
| D0230 | Intraoral - periapical each additional radiographic image | 21 | 21 | $230.20 |
| D0603 | 34 | 34 | $0.00 |