SOUTH TEXAS DENTAL ASSOCIATES, L.P.
NPI: 1447478847
· FT WORTH, TX 76110
· 1223G0001X
$826.66
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
39 |
$635.56 |
| 2019 |
14 |
$191.10 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
|
14 |
13 |
$459.16 |
| D1208 |
|
27 |
25 |
$367.50 |
| D0603 |
|
12 |
12 |
$0.00 |