THEODORSON, AMANDA
NPI: 1962737239
· WASHINGTON, DC 20009
· Dentist
· NPI assigned 10/05/2009
$831.44
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
105 |
$831.44 |
| 2021 |
14 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1208 |
Topical application of fluoride, excluding varnish |
21 |
18 |
$417.87 |
| D0120 |
Periodic oral evaluation - established patient |
14 |
13 |
$413.57 |
| D0999 |
Unspecified diagnostic procedure, by report |
84 |
72 |
$0.00 |