MELLON DENTAL MANAGEMENT, PLLC
NPI: 1336852144
· BANDERA, TX 78003
· Dental Clinic/Center
· NPI assigned 12/27/2022
Provider Details
| Authorized Official | MELLON, RANDI (DENTIST) |
| NPI Enumeration Date | 12/27/2022 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
106 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
13 |
13 |
$470.41 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$423.84 |
| D1206 |
Topical application of fluoride varnish |
27 |
27 |
$393.96 |
| D0220 |
Intraoral - periapical first radiographic image |
13 |
12 |
$87.92 |
| D0230 |
Intraoral - periapical each additional radiographic image |
12 |
12 |
$69.06 |
| D0603 |
|
29 |
27 |
$0.00 |