SOUTH TYLER FAMILY DENTISTRY PLLC
NPI: 1548636061
· TYLER, TX 75703
· Dentist
· NPI assigned 08/19/2015
Provider Details
| Authorized Official | GARCIA, JENNY (CREDENTIALING LEAD) |
| NPI Enumeration Date | 08/19/2015 |
Related Entities
Other providers sharing the same authorized official: GARCIA, JENNY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
115 |
$1K |
| 2021 |
1,691 |
$24K |
| 2022 |
578 |
$9K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
166 |
158 |
$8K |
| D0230 |
Intraoral - periapical each additional radiographic image |
635 |
284 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
230 |
216 |
$6K |
| D1120 |
Prophylaxis - child |
141 |
131 |
$4K |
| D1206 |
Topical application of fluoride varnish |
321 |
301 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
343 |
322 |
$4K |
| D1208 |
Topical application of fluoride, excluding varnish |
60 |
57 |
$807.26 |
| D0274 |
Bitewings - four radiographic images |
17 |
16 |
$515.69 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$279.03 |
| D0603 |
|
459 |
434 |
$0.00 |