GLORIA M LEE, DDS, PC
NPI: 1245540897
· NORTH POTOMAC, MD 20878
· General Practice Dentistry
· NPI assigned 10/18/2010
$654.04
Total Medicaid Paid
Provider Details
| Authorized Official | LEE, GLORIA (OWNER) |
| NPI Enumeration Date | 10/18/2010 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
25 |
$654.04 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$378.04 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$276.00 |