NPI: 1558434704 · GONZALES, LA 70737 · Dentist · NPI assigned 11/16/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 50 | $746.18 |
| 2019 | 176 | $3K |
| 2020 | 186 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0220 | Intraoral - periapical first radiographic image | 123 | 120 | $2K |
| D0272 | Bitewings - two radiographic images | 63 | 63 | $1K |
| D1110 | Prophylaxis - adult | 25 | 25 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 61 | 61 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 83 | 77 | $919.08 |
| D1120 | Prophylaxis - child | 28 | 28 | $875.50 |
| D0150 | Comprehensive oral evaluation - new or established patient | 12 | 12 | $568.44 |
| D0120 | Periodic oral evaluation - established patient | 17 | 17 | $463.08 |