LEGACY TRAILS DENTAL, PLLC
NPI: 1245684430
· PLANO, TX 75024
· Dental Clinic/Center
· NPI assigned 04/14/2016
Provider Details
Related Entities
Other providers sharing the same authorized official: AZMOODEH, AFSHIN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
242 |
$4K |
| 2023 |
380 |
$6K |
| 2024 |
370 |
$7K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
118 |
113 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
180 |
151 |
$4K |
| D1208 |
Topical application of fluoride, excluding varnish |
260 |
234 |
$3K |
| D0274 |
Bitewings - four radiographic images |
75 |
73 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
63 |
61 |
$729.92 |
| D0230 |
Intraoral - periapical each additional radiographic image |
61 |
59 |
$644.05 |
| D0601 |
|
98 |
96 |
$0.00 |
| D0603 |
|
137 |
112 |
$0.00 |