LEE, JAE
NPI: 1346658192
· SUWANEE, GA 30024
· General Practice Dentistry
· NPI assigned 07/24/2014
$229.92
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
13 |
$45.96 |
| 2019 |
29 |
$183.96 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
14 |
14 |
$126.68 |
| D0220 |
Intraoral - periapical first radiographic image |
28 |
28 |
$103.24 |