ALL STAR FAMILY DENTISTRY, PLLC
NPI: 1487904645
· LA FERIA, TX 78559
· General Practice Dentistry
· NPI assigned 09/14/2012
$134K
Total Medicaid Paid
Provider Details
| Authorized Official | TREVINO, JAVIER (PRESIDENT) |
| NPI Enumeration Date | 09/14/2012 |
Related Entities
Other providers sharing the same authorized official: TREVINO, JAVIER
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
100 |
$979.25 |
| 2021 |
1,864 |
$40K |
| 2022 |
1,667 |
$34K |
| 2023 |
1,775 |
$36K |
| 2024 |
1,320 |
$24K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,133 |
1,072 |
$30K |
| D1120 |
Prophylaxis - child |
582 |
563 |
$20K |
| D0145 |
Oral evaluation for a patient under three years of age |
126 |
126 |
$18K |
| D0274 |
Bitewings - four radiographic images |
575 |
540 |
$18K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,271 |
1,208 |
$18K |
| D1110 |
Prophylaxis - adult |
310 |
289 |
$15K |
| D0220 |
Intraoral - periapical first radiographic image |
699 |
647 |
$8K |
| D0230 |
Intraoral - periapical each additional radiographic image |
580 |
524 |
$6K |
| D0330 |
Panoramic radiographic image |
40 |
39 |
$2K |
| D0602 |
|
1,359 |
1,316 |
$0.00 |
| D0603 |
|
51 |
51 |
$0.00 |