NPI: 1790126142 · SEGUIN, TX 78155 · General Practice Dentistry · NPI assigned 07/15/2013
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 633 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 85 | 85 | $2K |
| D1120 | Prophylaxis - child | 56 | 56 | $2K |
| D1351 | Sealant - per tooth | 70 | 15 | $2K |
| D0145 | Oral evaluation for a patient under three years of age | 12 | 12 | $2K |
| D1206 | Topical application of fluoride varnish | 91 | 91 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 96 | 96 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 92 | 92 | $1K |
| D0274 | Bitewings - four radiographic images | 29 | 29 | $1K |
| D1110 | Prophylaxis - adult | 12 | 12 | $658.56 |
| D0603 | 90 | 90 | $0.00 |