NPI: 1679141014 · SUNNYVALE, TX 75182 · Dentist · NPI assigned 06/13/2021
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 246 | $10K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0145 | Oral evaluation for a patient under three years of age | 66 | 65 | $9K |
| D0120 | Periodic oral evaluation - established patient | 12 | 12 | $346.20 |
| D0230 | Intraoral - periapical each additional radiographic image | 22 | 12 | $230.20 |
| D0220 | Intraoral - periapical first radiographic image | 13 | 13 | $163.28 |
| D1208 | Topical application of fluoride, excluding varnish | 13 | 13 | $161.70 |
| D0603 | 120 | 119 | $0.00 |