SPOTSYLVANIA ORAL SURGERY PLLC
NPI: 1235517962
· SPOTSYLVANIA, VA 22553
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 05/14/2015
$1.31M
Total Medicaid Paid
Provider Details
| Authorized Official | MOODY, BRENDA (REGIONAL MANAGER) |
| NPI Enumeration Date | 05/14/2015 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
184 |
$13K |
| 2019 |
1,484 |
$88K |
| 2020 |
2,604 |
$141K |
| 2021 |
4,330 |
$373K |
| 2022 |
3,932 |
$484K |
| 2023 |
3,220 |
$206K |
| 2024 |
1,184 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
8,423 |
1,798 |
$792K |
| D7240 |
Removal of impacted tooth - completely bony |
902 |
338 |
$187K |
| D9310 |
|
1,858 |
1,512 |
$115K |
| D9243 |
|
1,025 |
548 |
$47K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
820 |
273 |
$38K |
| D7250 |
|
628 |
165 |
$31K |
| D0140 |
Limited oral evaluation - problem focused |
1,780 |
1,464 |
$31K |
| D9239 |
|
557 |
550 |
$25K |
| D9222 |
|
365 |
261 |
$17K |
| D7310 |
|
241 |
94 |
$17K |
| D0330 |
Panoramic radiographic image |
339 |
301 |
$6K |