STEWART, THOMAS
NPI: 1730443664
· MULESHOE, TX 79347
· Dentist
· NPI assigned 06/26/2012
$745.30
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
39 |
$745.30 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
13 |
13 |
$367.50 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$230.80 |
| D1206 |
Topical application of fluoride varnish |
14 |
14 |
$147.00 |