DAVIS, LEO
NPI: 1851602882
· LANCASTER, TX 75146
· Dentist
· NPI assigned 06/24/2010
$884.92
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
86 |
$884.92 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$343.35 |
| D1208 |
Topical application of fluoride, excluding varnish |
13 |
13 |
$191.10 |
| D0220 |
Intraoral - periapical first radiographic image |
15 |
15 |
$189.84 |
| D0230 |
Intraoral - periapical each additional radiographic image |
14 |
14 |
$160.63 |
| D0603 |
|
32 |
32 |
$0.00 |