NPI: 1215626452 · STEPHENVILLE, TX 76401 · General Practice Dentistry · NPI assigned 05/03/2023
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 175 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0230 | Intraoral - periapical each additional radiographic image | 64 | 20 | $535.22 |
| D1120 | Prophylaxis - child | 17 | 17 | $510.83 |
| D0120 | Periodic oral evaluation - established patient | 19 | 19 | $458.72 |
| D1208 | Topical application of fluoride, excluding varnish | 26 | 26 | $309.06 |
| D0220 | Intraoral - periapical first radiographic image | 22 | 22 | $206.56 |
| D0603 | 27 | 27 | $0.00 |