NPI: 1598257206 · BOERNE, TX 78006 · Student in an Organized Health Care Education/Training Program · NPI assigned 05/30/2018
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 16 | $220.50 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1208 | Topical application of fluoride, excluding varnish | 16 | 15 | $220.50 |