NOVA ORAL SURGERY LLC
NPI: 1225747736
· ADA, OK 74820
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 11/23/2022
$223K
Total Medicaid Paid
Provider Details
| Authorized Official | IGOU, HANS (OWNER) |
| NPI Enumeration Date | 11/23/2022 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
984 |
$148K |
| 2024 |
497 |
$75K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
811 |
234 |
$166K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
156 |
156 |
$34K |
| D9222 |
|
156 |
156 |
$12K |
| D0140 |
Limited oral evaluation - problem focused |
358 |
355 |
$11K |