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ANGELICA JANE BUSTOS THACKER, DMD

Dentist, General Practice · LAS VEGAS, NV

7603 GRAND TETON DR STE 140, LAS VEGAS, NV 89131

NPI Number
1073251963
Street View of 7603 GRAND TETON DR STE 140, LAS VEGAS, NV 89131

Practice location · View on Google Maps

Payments by Year

How much Medicaid paid this provider each year. Large jumps can indicate changes in practice volume or billing patterns.

Year Total Paid % of Max
2022$0

Procedure Code Breakdown

The specific medical services this provider billed Medicaid for. Each HCPCS/CPT code represents a different type of visit, test, or treatment.

HCPCS Code Description Claims Paid % of Total Avg per Claim
D0140Limited dental exam — for a specific problem (like a toothache)13$0
0.0%
$0
D0210Full set of dental X-rays23$0
0.0%
$0
D1110Dental cleaning for adults (prophylaxis)13$0
0.0%
$0
D0220Single dental X-ray (of one tooth)16$0
0.0%
$0
D0150Comprehensive dental exam — thorough check of teeth, gums, and mouth21$0
0.0%
$0
D1206Fluoride treatment — painted on teeth to prevent cavities14$0
0.0%
$0