TEDDER, DANIEL
NPI: 1376570929
· TROUTMAN, NC 28166
· General Practice Dentistry
· NPI assigned 06/27/2006
$977.33
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
38 |
$977.33 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
21 |
15 |
$627.30 |
| D0120 |
Periodic oral evaluation - established patient |
17 |
13 |
$350.03 |