BANDA, ESMERALDA
NPI: 1518698000
· GRAND PRAIRIE, TX 75051
· General Practice Dentistry
· NPI assigned 06/23/2022
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
158 |
$5K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0145 |
Oral evaluation for a patient under three years of age |
20 |
20 |
$3K |
| D1120 |
Prophylaxis - child |
15 |
15 |
$551.25 |
| D0120 |
Periodic oral evaluation - established patient |
14 |
14 |
$403.90 |
| D0230 |
Intraoral - periapical each additional radiographic image |
20 |
15 |
$333.79 |
| D1208 |
Topical application of fluoride, excluding varnish |
18 |
18 |
$264.60 |
| D0220 |
Intraoral - periapical first radiographic image |
18 |
18 |
$226.08 |
| D0603 |
|
53 |
53 |
$0.00 |