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AGNES S. MONDEJAR, D.D.S., INC.
AGNES S. MONDEJAR, D.D.S., INC.
NPI: 1952709230
· BREA, CA 92821
· General Practice Dentistry
· NPI assigned 12/18/2014
Provider Details
| Authorized Official | MONDEJAR, AGNES (PRESIDENT) |
| NPI Enumeration Date | 12/18/2014 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,801 |
$26K |
| 2019 |
268 |
$5K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
326 |
325 |
$11K |
| D1120 |
Prophylaxis - child |
342 |
341 |
$10K |
| D0272 |
Bitewings - two radiographic images |
343 |
342 |
$4K |
| D1208 |
Topical application of fluoride, excluding varnish |
335 |
334 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
711 |
369 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$385.00 |