NPI: 1790960367 · KATY, TX 77450 · Dentist · NPI assigned 01/02/2008
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 636 | $10K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 110 | 100 | $3K |
| D1351 | Sealant - per tooth | 81 | 27 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 105 | 101 | $1K |
| D1120 | Prophylaxis - child | 41 | 38 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 100 | 95 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 135 | 95 | $1K |
| D0274 | Bitewings - four radiographic images | 13 | 12 | $415.32 |
| D0272 | Bitewings - two radiographic images | 13 | 13 | $303.94 |
| D0601 | 16 | 14 | $0.00 | |
| D0602 | 22 | 22 | $0.00 |