COWBOYS DENTAL
NPI: 1164864708
· CARROLLTON, TX 75006
· Dentist
· NPI assigned 07/24/2013
$566.15
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
28 |
$566.15 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
14 |
13 |
$375.05 |
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
13 |
$191.10 |