LO, ERICA
NPI: 1255859955
· WASHINGTON, DC 20011
· General Practice Dentistry
· NPI assigned 09/01/2017
$817.55
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
70 |
$817.55 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
14 |
14 |
$458.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
15 |
15 |
$359.55 |
| D0999 |
Unspecified diagnostic procedure, by report |
41 |
38 |
$0.00 |