Home ›
MA ›
WORCESTER ›
CROMPTON PARK ORAL SURGERY AND IMPLANT ASSOCIATES, LLC
CROMPTON PARK ORAL SURGERY AND IMPLANT ASSOCIATES, LLC
NPI: 1033434659
· WORCESTER, MA 01610
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 04/07/2010
$112K
Total Medicaid Paid
Provider Details
| Authorized Official | KELLY, W DAVID (SOLE MEMBER) |
| NPI Enumeration Date | 04/07/2010 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
1,058 |
$76K |
| 2023 |
499 |
$36K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7140 |
Extraction, erupted tooth or exposed root |
1,112 |
321 |
$79K |
| D7240 |
Removal of impacted tooth - completely bony |
30 |
14 |
$8K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
92 |
71 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
165 |
161 |
$7K |
| D9222 |
|
82 |
80 |
$6K |
| D0330 |
Panoramic radiographic image |
76 |
75 |
$5K |