Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

SOUTH SHORE ORAL SURGERY ASSOCIATES CO. INC.

NPI: 1053462358 · QUINCY, MA 02169 · Oral and Maxillofacial Surgery (Dentist) · NPI assigned 01/15/2007

$44K
Total Medicaid Paid
525
Total Claims
415
Beneficiaries
6
Codes Billed
2019-05
First Month
2021-05
Last Month

Provider Details

Authorized OfficialLUSTBADER, DAVID (PRESIDENT)
NPI Enumeration Date01/15/2007

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 236 $14K
2020 260 $28K
2021 29 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D7240 Removal of impacted tooth - completely bony 36 12 $13K
D9223 Deep sedation/general anesthesia - each subsequent 15 minute increment 118 55 $10K
D0150 Comprehensive oral evaluation - new or established patient 217 206 $9K
D9222 71 68 $6K
D0330 Panoramic radiographic image 63 62 $4K
D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth 20 12 $2K