SOUHWEST ORAL SURGERY PC
NPI: 1134596166
· LAWTON, OK 73505
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 08/25/2015
$243K
Total Medicaid Paid
Provider Details
| Authorized Official | GRIGG, STEPHANIE (BUSINESS MANAGER) |
| NPI Enumeration Date | 08/25/2015 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
352 |
$43K |
| 2022 |
1,368 |
$152K |
| 2023 |
466 |
$49K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
680 |
227 |
$136K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
371 |
371 |
$39K |
| D9222 |
|
372 |
372 |
$27K |
| D9310 |
|
362 |
360 |
$17K |
| D7230 |
|
69 |
39 |
$11K |
| D9610 |
|
278 |
278 |
$8K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
54 |
27 |
$5K |