NPI: 1699087973 · MIDLAND, TX 79701 · Dentist · NPI assigned 07/02/2010
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 104 | $417.76 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 20 | 14 | $173.04 |
| D1206 | Topical application of fluoride varnish | 20 | 14 | $88.20 |
| D0220 | Intraoral - periapical first radiographic image | 22 | 15 | $81.64 |
| D0230 | Intraoral - periapical each additional radiographic image | 22 | 15 | $74.88 |
| D0603 | 20 | 14 | $0.00 |