NPI: 1760938450 · SEGUIN, TX 78155 · Dentist · NPI assigned 09/01/2016
| Authorized Official | GAJERA, PRASHANTKUMAR (OWNER) |
| NPI Enumeration Date | 09/01/2016 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 116 | $1K |
| 2023 | 74 | $674.29 |
| 2024 | 366 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0220 | Intraoral - periapical first radiographic image | 187 | 170 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | 189 | 146 | $2K |
| D0274 | Bitewings - four radiographic images | 26 | 24 | $729.70 |
| D1208 | Topical application of fluoride, excluding varnish | 33 | 32 | $411.96 |
| D0120 | Periodic oral evaluation - established patient | 12 | 12 | $343.35 |
| D1206 | Topical application of fluoride varnish | 14 | 13 | $147.00 |
| D0603 | 95 | 95 | $0.00 |