NPI: 1205053394 · FRISCO, TX 75033 · General Practice Dentistry · NPI assigned 04/19/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 83 | $1K |
| 2021 | 177 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 58 | 58 | $852.60 |
| D0120 | Periodic oral evaluation - established patient | 25 | 25 | $721.25 |
| D0150 | Comprehensive oral evaluation - new or established patient | 16 | 16 | $565.12 |
| D1120 | Prophylaxis - child | 16 | 16 | $551.25 |
| D0220 | Intraoral - periapical first radiographic image | 27 | 27 | $339.12 |
| D0230 | Intraoral - periapical each additional radiographic image | 27 | 27 | $310.77 |
| D1999 | 78 | 73 | $0.00 | |
| D0602 | 13 | 13 | $0.00 |