RODRIGUEZ, LIZZETH
NPI: 1154882181
· LEWISVILLE, TX 75077
· General Practice Dentistry
· NPI assigned 03/31/2019
$414.49
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
162 |
$288.89 |
| 2024 |
14 |
$125.60 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0220 |
Intraoral - periapical first radiographic image |
32 |
28 |
$150.72 |
| D1120 |
Prophylaxis - child |
22 |
18 |
$110.25 |
| D0230 |
Intraoral - periapical each additional radiographic image |
43 |
14 |
$80.57 |
| D1208 |
Topical application of fluoride, excluding varnish |
27 |
23 |
$44.10 |
| D0120 |
Periodic oral evaluation - established patient |
17 |
16 |
$28.85 |
| D0603 |
|
35 |
28 |
$0.00 |