WILSHIRE ORAL SURGERY & IMPLANT CENTER
NPI: 1205370319
· LOS ANGELES, CA 90025
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 12/08/2016
$854K
Total Medicaid Paid
Provider Details
| Authorized Official | SHADI, JONATHAN (PRESIDENT) |
| NPI Enumeration Date | 12/08/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
167 |
$9K |
| 2020 |
320 |
$15K |
| 2021 |
1,353 |
$109K |
| 2022 |
1,958 |
$161K |
| 2023 |
3,085 |
$282K |
| 2024 |
3,245 |
$278K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,116 |
767 |
$305K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,607 |
2,595 |
$172K |
| D9222 |
|
771 |
766 |
$93K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
655 |
365 |
$77K |
| D0330 |
Panoramic radiographic image |
2,432 |
2,418 |
$72K |
| D9610 |
|
1,124 |
766 |
$63K |
| D9430 |
|
1,293 |
1,233 |
$41K |
| D7240 |
Removal of impacted tooth - completely bony |
130 |
51 |
$30K |