NPI: 1366613978 · GEORGETOWN, TX 78628 · Pediatric Dentist · NPI assigned 03/22/2008
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 96 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 12 | 12 | $441.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 12 | 12 | $423.84 |
| D0120 | Periodic oral evaluation - established patient | 13 | 13 | $346.20 |
| D0272 | Bitewings - two radiographic images | 13 | 13 | $280.56 |
| D1208 | Topical application of fluoride, excluding varnish | 14 | 14 | $205.80 |
| D0603 | 32 | 32 | $0.00 |