NPI: 1366972911 · ADDISON, TX 75254 · General Practice Dentistry · NPI assigned 06/15/2017
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 14 | $0.00 |
| 2023 | 242 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0145 | Oral evaluation for a patient under three years of age | 26 | 26 | $4K |
| D1120 | Prophylaxis - child | 14 | 13 | $441.00 |
| D0120 | Periodic oral evaluation - established patient | 16 | 15 | $403.90 |
| D0230 | Intraoral - periapical each additional radiographic image | 37 | 16 | $368.32 |
| D1208 | Topical application of fluoride, excluding varnish | 17 | 16 | $220.50 |
| D0220 | Intraoral - periapical first radiographic image | 17 | 16 | $200.96 |
| D0603 | 129 | 127 | $0.00 |