NPI: 1316408115 · BAY CITY, TX 77414 · Dental Clinic/Center · NPI assigned 03/26/2019
| Authorized Official | GADE, HANUMAN (PRESIDENT) |
| NPI Enumeration Date | 03/26/2019 |
Other providers sharing the same authorized official: GADE, HANUMAN
| Provider | City | State | Total Paid |
|---|---|---|---|
| UR SMILE DENTAL OF CLUTE PLLC | CLUTE | TX | $152K |
| KATY FAMILY DENTISTRY | KATY | TX | $89K |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 13 | $0.00 |
| 2021 | 581 | $6K |
| 2022 | 1,151 | $15K |
| 2023 | 606 | $7K |
| 2024 | 257 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 268 | 261 | $7K |
| D0220 | Intraoral - periapical first radiographic image | 509 | 484 | $5K |
| D0230 | Intraoral - periapical each additional radiographic image | 557 | 331 | $5K |
| D1208 | Topical application of fluoride, excluding varnish | 316 | 309 | $4K |
| D0274 | Bitewings - four radiographic images | 116 | 111 | $3K |
| D1120 | Prophylaxis - child | 69 | 68 | $2K |
| D1351 | Sealant - per tooth | 80 | 13 | $2K |
| D1110 | Prophylaxis - adult | 36 | 36 | $2K |
| D0603 | 657 | 645 | $0.00 |