SOUTH TEXAS DENTAL ASSOCIATES, LP
NPI: 1952742876
· FT WORTH, TX 76115
· 1223G0001X
$360.36
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
49 |
$360.36 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0230 |
|
21 |
12 |
$184.52 |
| D0220 |
|
14 |
14 |
$175.84 |
| D0603 |
|
14 |
14 |
$0.00 |