NPI: 1750939047 · HUMBLE, TX 77338 · Dentist · NPI assigned 08/29/2019
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 83 | $2K |
| 2023 | 12 | $150.72 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 15 | 15 | $524.48 |
| D1120 | Prophylaxis - child | 12 | 12 | $434.25 |
| D0220 | Intraoral - periapical first radiographic image | 28 | 28 | $339.12 |
| D0272 | Bitewings - two radiographic images | 12 | 12 | $280.56 |
| D1206 | Topical application of fluoride varnish | 12 | 12 | $176.40 |
| D0230 | Intraoral - periapical each additional radiographic image | 16 | 16 | $172.65 |