SANTIAGO, JOAN
NPI: 1841236502
· WACO, TX 76707
· Dentist
· NPI assigned 06/21/2006
$828.94
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
12 |
$68.94 |
| 2022 |
25 |
$222.50 |
| 2023 |
29 |
$537.50 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
14 |
14 |
$350.00 |
| D1206 |
Topical application of fluoride varnish |
28 |
28 |
$350.00 |
| D0220 |
Intraoral - periapical first radiographic image |
24 |
24 |
$128.94 |