NPI: 1962776617 · GAINESVILLE, TX 76240 · Student in an Organized Health Care Education/Training Program · NPI assigned 02/27/2012
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 14 | $0.00 |
| 2021 | 264 | $4K |
| 2022 | 587 | $11K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 131 | 131 | $5K |
| D0120 | Periodic oral evaluation - established patient | 107 | 107 | $3K |
| D1208 | Topical application of fluoride, excluding varnish | 167 | 167 | $2K |
| D1110 | Prophylaxis - adult | 26 | 26 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 92 | 92 | $1K |
| D0272 | Bitewings - two radiographic images | 35 | 35 | $794.92 |
| D0230 | Intraoral - periapical each additional radiographic image | 72 | 54 | $782.68 |
| D0603 | 235 | 232 | $0.00 |