Dental
Smile Kings Bandera, PLLC
Smile Kings Bandera, PLLC was paid $3.28M by Medicaid between Nov 2020 and Dec 2024, across 19 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 16% of everything it billed.
33Billing provider infoSMILE KINGS BANDERA, PLLC
SAN ANTONIO, TX 78228
SAN ANTONIO, TX 78228
33aNPI1447681606assigned 12/12/2013
33bProvider typeGeneral Practice Dentistry
28Total paid$3.28M
24GClaims121,031
24DCodes billed19
24AFirst – last monthNov 2020 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Texas
Rank by total paid#105 of 2,774
Median peer was paid$43K
This provider vs. median77×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2020 | 1,980 | $53K | |
| 2021 | 29,675 | $762K | |
| 2022 | 32,820 | $881K | |
| 2023 | 32,729 | $901K | |
| 2024incomplete | 23,827 | $686K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 16% | 5,399 | 2,593 | $530K |
| D1351 | Sealant - per tooth | 11% | 14,084 | 2,976 | $360K |
| D0145 | Oral evaluation for a patient under three years of age | 11% | 2,497 | 2,486 | $348K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 9.1% | 10,722 | 10,662 | $300K |
| D1120 | Dental cleaning, childProphylaxis - child | 8.0% | 7,347 | 7,315 | $261K |
| D1110 | Prophylaxis - adult | 7.8% | 4,900 | 4,866 | $256K |
| D1208 | Topical application of fluoride, excluding varnish | 5.6% | 12,865 | 12,798 | $183K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.3% | 2,314 | 1,275 | $175K |
| D0230 | Intraoral - periapical each additional radiographic image | 5.0% | 15,459 | 11,835 | $166K |
| D0274 | Bitewings - four radiographic images | 5.0% | 5,053 | 5,016 | $165K |
| D0220 | Intraoral - periapical first radiographic image | 4.5% | 12,539 | 12,418 | $148K |
| D0210 | Intraoral - complete series of radiographic images | 3.4% | 1,662 | 1,650 | $112K |
7 more codes
| D0272 | Bitewings - two radiographic images | 3.3% | 4,773 | $108K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.3% | 2,221 | $76K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 1.5% | 332 | $48K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.2% | 1,465 | $39K |
| D0330 | Panoramic radiographic image | <1% | 219 | $6K |
| D0140 | Limited oral evaluation - problem focused | <1% | 142 | $2K |
| D0603 | 0% | 17,038 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialTORBATI, ALI (OWNER/DENTIST)