FISHERS ORAL & MAXILLOFACIAL SURGERY

NPI: 1174534515 · FISHERS, IN 46038 · Oral and Maxillofacial Surgery (Dentist) · NPI assigned 08/10/2006

$526.52

Total Medicaid Paid

Total Claims

Beneficiaries

Codes Billed

2018-06

First Month

2020-06

Last Month

Provider Details

Authorized Official	BENNETT, MICHAEL (PRESIDENT SURGEON)
NPI Enumeration Date	08/10/2006

Other providers sharing the same authorized official: BENNETT, MICHAEL

Provider	City	State	Total Paid
HALE MAKA IKE LLC	HONOLULU	HI	$920K
GUTHRIE VISION SOURCE PC, INC.	GUTHRIE	OK	$665K
CENTER FOR SIGHT - WEST OAHU LLC	HONOLULU	HI	$366K
RETINA INSTITUTE OF HAWAII LLC	KAILUA KONA	HI	$348K
CENTER FOR SIGHT LLC	KAHULUI	HI	$157K
HAWAII CATARACT AND LASER INSTITUTE HILO LLC	HILO	HI	$82K
MICHAEL J BENNETT	JUNEAU	AK	$73K
SANDSTONE DENTAL OFFICE	SANDSTONE	MN	$70K
THOUSAND ISLANDS EMERGENCY RESCUE SERVICE INC	CLAYTON	NY	$54K
EYE CENTER OF HAWAII LLC	KAILUA KONA	HI	$2K

Year	Claims	Total Paid
2018	15	$148.32
2020	15	$378.20

Code	Description	Claims	Beneficiaries	Total Paid
D0140	Limited oral evaluation - problem focused	30	26	$526.52