LEBSACK, TIMOTHY
NPI: 1134205412
· HASTINGS, NE 68901
· Dentist
· NPI assigned 10/28/2006
$897.88
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
12 |
$264.00 |
| 2019 |
27 |
$633.88 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
27 |
27 |
$599.28 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$298.60 |