NPI: 1851602882 · LANCASTER, TX 75146 · Dentist · NPI assigned 06/24/2010
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 86 | $884.92 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 12 | 12 | $343.35 |
| D1208 | Topical application of fluoride, excluding varnish | 13 | 13 | $191.10 |
| D0220 | Intraoral - periapical first radiographic image | 15 | 15 | $189.84 |
| D0230 | Intraoral - periapical each additional radiographic image | 14 | 14 | $160.63 |
| D0603 | 32 | 32 | $0.00 |