FOOTHILLS ORAL AND MAXILLOFACIAL SURGERY, PC
NPI: 1154407088
· LENOIR CITY, TN 37771
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 10/31/2006
$102K
Total Medicaid Paid
Provider Details
| Authorized Official | GROSS, KEVIN (DDS/OWNER) |
| NPI Enumeration Date | 10/31/2006 |
Related Entities
Other providers sharing the same authorized official: GROSS, KEVIN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
486 |
$44K |
| 2019 |
363 |
$31K |
| 2020 |
262 |
$12K |
| 2021 |
341 |
$15K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
391 |
298 |
$32K |
| D9222 |
|
283 |
278 |
$24K |
| D7230 |
|
87 |
25 |
$15K |
| D7240 |
Removal of impacted tooth - completely bony |
64 |
26 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
226 |
225 |
$7K |
| D0140 |
Limited oral evaluation - problem focused |
240 |
236 |
$6K |
| D7140 |
Extraction, erupted tooth or exposed root |
42 |
14 |
$3K |
| D0330 |
Panoramic radiographic image |
25 |
25 |
$768.30 |
| D1999 |
|
94 |
91 |
$0.00 |