SUE K MOON DDS PC
NPI: 1922345016
· LEESBURG, VA 20175
· General Practice Dentistry
· NPI assigned 01/09/2013
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | MOON, SUE (DOCTOR) |
| NPI Enumeration Date | 01/09/2013 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
70 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
27 |
27 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
30 |
29 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$0.00 |