NPI: 1275226763 · NEW BRAUNFELS, TX 78130 · General Practice Dentistry · NPI assigned 05/31/2023
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 180 | $3K |
| 2024 | 216 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 70 | 68 | $2K |
| D1206 | Topical application of fluoride varnish | 67 | 65 | $940.80 |
| D0220 | Intraoral - periapical first radiographic image | 62 | 59 | $727.88 |
| D1110 | Prophylaxis - adult | 14 | 13 | $713.44 |
| D0274 | Bitewings - four radiographic images | 18 | 17 | $588.37 |
| D1120 | Prophylaxis - child | 13 | 13 | $477.75 |
| D0230 | Intraoral - periapical each additional radiographic image | 43 | 34 | $448.89 |
| D0603 | 109 | 109 | $0.00 |