Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › KS › NEWTON › TERRY L. DAVIDSON, D.D.S., P.A.

TERRY L. DAVIDSON, D.D.S., P.A.

NPI: 1306941471 · NEWTON, KS 67114 · General Practice Dentistry · NPI assigned 09/14/2006

$10K
Total Medicaid Paid
461
Total Claims
455
Beneficiaries
5
Codes Billed
2018-01
First Month
2018-12
Last Month

Provider Details

Authorized OfficialDAVIDSON, TERRY (PRESIDENT)
NPI Enumeration Date09/14/2006

Related Entities

Other providers sharing the same authorized official: DAVIDSON, TERRY

ProviderCityStateTotal Paid
COMANCHE PUBLIC SCHOOLS COMANCHE OK $5K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 461 $10K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 184 180 $4K
D1208 Topical application of fluoride, excluding varnish 158 156 $3K
D1110 Prophylaxis - adult 61 61 $2K
D1120 Prophylaxis - child 44 44 $1K
D0274 Bitewings - four radiographic images 14 14 $348.00