NPI: 1508351016 · MAGNOLIA, TX 77354 · Dentist · NPI assigned 06/27/2018
| Authorized Official | LOPEZ, RUBEN (DIRECTOR OF OPERATIONS) |
| NPI Enumeration Date | 06/27/2018 |
Other providers sharing the same authorized official: LOPEZ, RUBEN
| Provider | City | State | Total Paid |
|---|---|---|---|
| PORT ORANGE PEDIATRICS P A | PORT ORANGE | FL | $1.28M |
| TRINITY LAREDO DENTAL PLLC | LAREDO | TX | $14K |
| TRINITY SPRING DENTAL PLLC | SPRING | TX | $7K |
| MED ZONE DME LLC | RIO GRANDE CITY | TX | $4K |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 264 | $6K |
| 2021 | 1,443 | $25K |
| 2022 | 3,403 | $76K |
| 2023 | 1,561 | $28K |
| 2024 | 2,956 | $64K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | 1,018 | 978 | $28K | |
| D1110 | 497 | 485 | $25K | |
| D2392 | 267 | 111 | $25K | |
| D1120 | 665 | 650 | $23K | |
| D1208 | 1,488 | 1,451 | $21K | |
| D0220 | 1,357 | 1,299 | $16K | |
| D0230 | 1,306 | 1,193 | $14K | |
| D0274 | 344 | 330 | $10K | |
| D2391 | 119 | 66 | $9K | |
| D1351 | 307 | 40 | $8K | |
| D0150 | 245 | 223 | $7K | |
| D0272 | 306 | 298 | $7K | |
| D0350 | 281 | 269 | $4K | |
| D0210 | 30 | 30 | $2K | |
| D0145 | 13 | 13 | $2K | |
| D1330 | 13 | 13 | $159.75 | |
| D0603 | 807 | 795 | $54.21 | |
| D0602 | 359 | 358 | $0.00 | |
| D0601 | 205 | 202 | $0.00 |