GANTAYAT, SANGEETA
NPI: 1407284128
· WACO, TX 76710
· Dentist
· NPI assigned 10/15/2013
$535.05
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
119 |
$263.06 |
| 2024 |
28 |
$271.99 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
31 |
28 |
$198.45 |
| D1120 |
Prophylaxis - child |
13 |
12 |
$183.79 |
| D0230 |
Intraoral - periapical each additional radiographic image |
48 |
12 |
$108.83 |
| D0220 |
Intraoral - periapical first radiographic image |
13 |
12 |
$43.96 |
| D0603 |
|
42 |
39 |
$0.02 |