TIBERI, LISA
NPI: 1023298452
· LARCHMONT, NY 10538
· General Practice Dentistry
· NPI assigned 11/14/2007
$864.75
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
57 |
$482.25 |
| 2020 |
12 |
$382.50 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
42 |
42 |
$864.75 |
| D1208 |
Topical application of fluoride, excluding varnish |
15 |
15 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$0.00 |