DANIEL T. ESTACIO, DDS, INC.
NPI: 1649467291
· GLENDALE, CA 91205
· Preferred Provider Organization
· NPI assigned 09/27/2007
$105K
Total Medicaid Paid
Provider Details
| Authorized Official | ESTACIO, DANIEL (DENTIST/PRESIDENT) |
| NPI Enumeration Date | 09/27/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,833 |
$13K |
| 2019 |
1,478 |
$11K |
| 2020 |
1,665 |
$18K |
| 2021 |
1,725 |
$15K |
| 2022 |
1,884 |
$20K |
| 2023 |
1,292 |
$12K |
| 2024 |
1,323 |
$16K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0230 |
Intraoral - periapical each additional radiographic image |
8,945 |
1,756 |
$37K |
| D0120 |
Periodic oral evaluation - established patient |
573 |
569 |
$31K |
| D1110 |
Prophylaxis - adult |
170 |
170 |
$14K |
| D0272 |
Bitewings - two radiographic images |
1,176 |
1,168 |
$14K |
| D1120 |
Prophylaxis - child |
177 |
177 |
$6K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
23 |
13 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
136 |
136 |
$1K |