Whitewater Oral Surgery Group PLLC

Whitewater Oral Surgery Group PLLC was paid $17K by Medicaid between Aug 2018 and Oct 2021, across 6 billing codes. Its largest line is D7240, Removal of impacted tooth - completely bony — 46% of everything it billed.

33Billing provider infoWHITEWATER ORAL SURGERY GROUP PLLC
BOISE, ID 83702

33aNPI1104248053assigned 01/13/2014

33bProvider typeOral and Maxillofacial Surgery (Dentist)

28Total paid$17K

24GClaims876

24DCodes billed6

24AFirst – last monthAug 2018 – Oct 2021

Compared with peers

Next to other Oral and Maxillofacial Surgery (Dentist) providers in Idaho

Rank by total paid#10 of 14

Median peer was paid$39K

This provider vs. median0.4×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	25	$296.58
2019	29	$488.70
2020	366	$12K
2021	456	$4K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D7240	Removal of impacted tooth - completely bony	46%	38	12	$8K
D0140	Limited oral evaluation - problem focused	36%	254	253	$6K
D0150	Comprehensive oral evaluation - new or established patient	12%	129	129	$2K
D0330	Panoramic radiographic image	5.0%	53	52	$831.39
D9222		1.0%	186	185	$169.46
D9223	Deep sedation/general anesthesia - each subsequent 15 minute increment	0%	216	146	$0.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialKEMPERS, KEVIN (OWNER)