WICHITA ORAL SURGERY LLC
NPI: 1164914982
· WICHITA, KS 67206
· Oral and Maxillofacial Surgery Clinic/Center
· NPI assigned 06/06/2018
$527K
Total Medicaid Paid
Provider Details
| Authorized Official | ROE, ANGELIKA (CREDENTIALING) |
| NPI Enumeration Date | 06/06/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
27 |
$783.36 |
| 2023 |
2,917 |
$209K |
| 2024 |
3,113 |
$316K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
867 |
277 |
$163K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
990 |
622 |
$104K |
| D7241 |
|
295 |
106 |
$73K |
| D9222 |
|
681 |
630 |
$66K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
248 |
88 |
$46K |
| D0140 |
Limited oral evaluation - problem focused |
773 |
720 |
$28K |
| D9610 |
|
667 |
621 |
$16K |
| D9219 |
|
653 |
598 |
$16K |
| D0330 |
Panoramic radiographic image |
294 |
271 |
$8K |
| D7230 |
|
49 |
27 |
$7K |
| D7922 |
|
540 |
142 |
$0.00 |