NPI: 1619262722 · BROWNWOOD, TX 76801 · Dentist · NPI assigned 06/16/2011
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 657 | $12K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 88 | 88 | $3K |
| D0120 | Periodic oral evaluation - established patient | 89 | 89 | $3K |
| D0145 | Oral evaluation for a patient under three years of age | 16 | 16 | $2K |
| D1206 | Topical application of fluoride varnish | 95 | 95 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 103 | 103 | $1K |
| D0272 | Bitewings - two radiographic images | 51 | 51 | $981.96 |
| D0230 | Intraoral - periapical each additional radiographic image | 95 | 93 | $874.76 |
| D0603 | 120 | 120 | $0.00 |