SOURI, SAMAN
NPI: 1114241452
· HARLEYSVILLE, PA 19438
· Dentist
· NPI assigned 03/15/2010
$420K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
951 |
$141K |
| 2019 |
876 |
$114K |
| 2020 |
765 |
$114K |
| 2021 |
498 |
$51K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
734 |
254 |
$194K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
608 |
555 |
$104K |
| D9222 |
|
565 |
554 |
$39K |
| D9310 |
|
776 |
753 |
$36K |
| D7230 |
|
157 |
75 |
$28K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
161 |
83 |
$15K |
| D0330 |
Panoramic radiographic image |
76 |
74 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$306.39 |