AL-DAGGISTANY, MARWAN
NPI: 1245837152
· PROSPER, TX 75078
· Dentist
· NPI assigned 10/04/2020
$717.08
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
27 |
$231.56 |
| 2024 |
41 |
$485.52 |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$340.50 |
| D0220 |
Intraoral - periapical first radiographic image |
26 |
25 |
$273.50 |
| D0230 |
Intraoral - periapical each additional radiographic image |
13 |
12 |
$103.08 |
| D0603 |
|
17 |
16 |
$0.00 |