PORT LAVACA DENTISTRY PLLC
NPI: 1881005296
· PORT LAVACA, TX 77979
· Dentist
· NPI assigned 05/20/2014
Provider Details
| Authorized Official | LOPEZ, PAOLA (PAYER ENROLLMENT TEAM LEAD) |
| NPI Enumeration Date | 05/20/2014 |
Related Entities
Other providers sharing the same authorized official: LOPEZ, PAOLA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
112 |
$2K |
| 2022 |
456 |
$8K |
| 2023 |
315 |
$5K |
| 2024 |
107 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
231 |
224 |
$6K |
| D1120 |
Prophylaxis - child |
138 |
136 |
$5K |
| D1206 |
Topical application of fluoride varnish |
295 |
285 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
106 |
103 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
53 |
49 |
$494.93 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$176.40 |
| D0603 |
|
73 |
71 |
$0.00 |
| D0601 |
|
82 |
82 |
$0.00 |