NPI: 1528331113 · CEDAR PARK, TX 78613 · General Practice Dentistry · NPI assigned 02/14/2012
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 456 | $8K |
| 2022 | 259 | $4K |
| 2023 | 134 | $939.65 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 147 | 135 | $4K |
| D1208 | Topical application of fluoride, excluding varnish | 209 | 201 | $3K |
| D1110 | Prophylaxis - adult | 43 | 41 | $2K |
| D0274 | Bitewings - four radiographic images | 42 | 40 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 96 | 90 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 101 | 64 | $943.53 |
| D1120 | Prophylaxis - child | 12 | 12 | $441.00 |
| D0601 | 199 | 188 | $0.00 |