NPI: 1770713679 · PASADENA, TX 77502 · General Practice Dentistry · NPI assigned 07/26/2009
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 57 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 13 | 13 | $477.75 |
| D1208 | Topical application of fluoride, excluding varnish | 15 | 15 | $220.50 |
| D0230 | Intraoral - periapical each additional radiographic image | 16 | 13 | $172.65 |
| D0220 | Intraoral - periapical first radiographic image | 13 | 13 | $163.28 |