BLACK HILLS ORAL & MAXILLOFACIAL SURGERY PC
NPI: 1063486926
· RAPID CITY, SD 57701
· Oral and Maxillofacial Pathology Dentist
· NPI assigned 02/15/2006
$3.18M
Total Medicaid Paid
Provider Details
| Authorized Official | WILSON, ROGER (PRESIDENT) |
| NPI Enumeration Date | 02/15/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,153 |
$189K |
| 2019 |
2,537 |
$254K |
| 2020 |
1,290 |
$137K |
| 2021 |
2,994 |
$349K |
| 2022 |
4,333 |
$536K |
| 2023 |
4,041 |
$616K |
| 2024 |
5,216 |
$1.09M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
5,370 |
2,032 |
$911K |
| D7240 |
Removal of impacted tooth - completely bony |
2,123 |
869 |
$668K |
| D9222 |
|
2,859 |
2,818 |
$382K |
| D7140 |
Extraction, erupted tooth or exposed root |
3,308 |
993 |
$309K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,171 |
1,797 |
$271K |
| D7230 |
|
898 |
520 |
$237K |
| D0140 |
Limited oral evaluation - problem focused |
4,380 |
4,338 |
$201K |
| 70486 |
|
1,442 |
1,418 |
$194K |
| D0330 |
Panoramic radiographic image |
13 |
13 |
$753.80 |