DAON
NPI: 1114547304
· GLENDALE, AZ 85302
· Endodontist
· NPI assigned 04/17/2020
$198.23
Total Medicaid Paid
Provider Details
| Authorized Official | LEE, SANDRA (ENDODONTIST) |
| NPI Enumeration Date | 04/17/2020 |
Related Entities
Other providers sharing the same authorized official: LEE, SANDRA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
113 |
$198.23 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0140 |
Limited oral evaluation - problem focused |
34 |
34 |
$107.82 |
| D0230 |
Intraoral - periapical each additional radiographic image |
44 |
44 |
$46.76 |
| D0220 |
Intraoral - periapical first radiographic image |
35 |
35 |
$43.65 |