NPI: 1497837587 · TYLER, TX 75703 · Pediatric Dentist · NPI assigned 10/19/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 640 | $9K |
| 2024 | 12 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 91 | 88 | $3K |
| D1351 | Sealant - per tooth | 109 | 25 | $2K |
| D0120 | Periodic oral evaluation - established patient | 63 | 61 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 109 | 106 | $1K |
| D0272 | Bitewings - two radiographic images | 45 | 45 | $794.92 |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 27 | 27 | $487.98 |
| D0220 | Intraoral - periapical first radiographic image | 55 | 49 | $464.72 |
| D0230 | Intraoral - periapical each additional radiographic image | 18 | 16 | $184.16 |
| D0603 | 123 | 118 | $0.00 | |
| D0191 | 12 | 12 | $0.00 |