SOUTHEAST ORAL SURGERY PC
NPI: 1184733446
· MARYVILLE, TN 37804
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 08/30/2006
$898K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,027 |
$41K |
| 2019 |
2,072 |
$128K |
| 2020 |
1,384 |
$73K |
| 2021 |
2,090 |
$117K |
| 2022 |
3,372 |
$244K |
| 2023 |
2,326 |
$165K |
| 2024 |
2,188 |
$129K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9222 |
|
2,692 |
2,633 |
$229K |
| D7240 |
Removal of impacted tooth - completely bony |
902 |
301 |
$212K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,899 |
1,230 |
$160K |
| D0140 |
Limited oral evaluation - problem focused |
5,597 |
5,558 |
$133K |
| D7230 |
|
340 |
117 |
$67K |
| D9612 |
|
878 |
862 |
$39K |
| D9610 |
|
1,585 |
1,546 |
$34K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
126 |
56 |
$14K |
| D0330 |
Panoramic radiographic image |
404 |
402 |
$7K |
| D7140 |
Extraction, erupted tooth or exposed root |
36 |
13 |
$2K |