TEDMAN, ELIZABETH
NPI: 1316932320
· SABETHA, KS 66534
· General Practice Dentistry
· NPI assigned 09/15/2005
$456.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
24 |
$456.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$252.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$204.00 |