SUNRAY FAMILY DENTISTRY PLLC
NPI: 1629721782
· SOCORRO, TX 79927
· General Practice Dentistry
· NPI assigned 01/29/2022
$638.70
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
108 |
$638.70 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1208 |
Topical application of fluoride, excluding varnish |
24 |
24 |
$349.86 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$150.72 |
| D0230 |
Intraoral - periapical each additional radiographic image |
12 |
12 |
$138.12 |
| D0602 |
|
60 |
60 |
$0.00 |