ANDES DENTAL PLLC
NPI: 1346759487
· ODESSA, TX 79762
· General Practice Dentistry
· NPI assigned 09/20/2017
$734.87
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
42 |
$584.93 |
| 2022 |
13 |
$149.94 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$385.01 |
| D1208 |
Topical application of fluoride, excluding varnish |
28 |
28 |
$349.86 |
| D0603 |
|
15 |
14 |
$0.00 |