ALTUVE CARDONA, MAURICE
NPI: 1407551468
· AUSTIN, TX 78737
· Student in an Organized Health Care Education/Training Program
· NPI assigned 03/31/2023
$638.05
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
124 |
$638.05 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
13 |
13 |
$276.94 |
| D0120 |
Periodic oral evaluation - established patient |
14 |
14 |
$190.80 |
| D0220 |
Intraoral - periapical first radiographic image |
40 |
39 |
$73.49 |
| D0230 |
Intraoral - periapical each additional radiographic image |
42 |
36 |
$49.02 |
| D0274 |
Bitewings - four radiographic images |
15 |
15 |
$47.80 |