NPI: 1366587065 · MISSOURI CITY, TX 77459 · Dentist · NPI assigned 02/20/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 146 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 16 | 16 | $588.00 |
| D0120 | Periodic oral evaluation - established patient | 19 | 19 | $548.15 |
| D1208 | Topical application of fluoride, excluding varnish | 23 | 23 | $338.10 |
| D0230 | Intraoral - periapical each additional radiographic image | 29 | 21 | $333.79 |
| D0220 | Intraoral - periapical first radiographic image | 23 | 23 | $288.88 |
| D0272 | Bitewings - two radiographic images | 12 | 12 | $280.56 |
| D0603 | 24 | 24 | $0.00 |