EVANS, EVERETT
NPI: 1407930050
· DENTON, TX 76209
· Dentist
· NPI assigned 10/24/2006
$918.22
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
75 |
$918.22 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$346.20 |
| D0230 |
Intraoral - periapical each additional radiographic image |
20 |
12 |
$230.20 |
| D1208 |
Topical application of fluoride, excluding varnish |
13 |
13 |
$191.10 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$150.72 |
| D0603 |
|
18 |
18 |
$0.00 |