MISSOULA ORAL SURGERY
NPI: 1255620928
· MISSOULA, MT 59801
· Oral and Maxillofacial Surgery Clinic/Center
· NPI assigned 04/04/2011
$7.99M
Total Medicaid Paid
Provider Details
| Authorized Official | WISWELL, GRANT (OWNER/SURGEON) |
| NPI Enumeration Date | 04/04/2011 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
7,474 |
$1.11M |
| 2019 |
9,021 |
$1.32M |
| 2020 |
7,800 |
$1.15M |
| 2021 |
8,471 |
$1.26M |
| 2022 |
9,067 |
$1.31M |
| 2023 |
6,742 |
$1.08M |
| 2024 |
4,883 |
$756K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
7,221 |
2,649 |
$1.76M |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
11,970 |
4,368 |
$1.51M |
| D0367 |
|
4,911 |
4,774 |
$1.34M |
| D9243 |
|
7,176 |
6,838 |
$1.13M |
| D9239 |
|
6,956 |
6,664 |
$532K |
| D7230 |
|
2,307 |
1,416 |
$456K |
| D9310 |
|
6,646 |
6,475 |
$359K |
| D7241 |
|
807 |
475 |
$256K |
| D7250 |
|
1,639 |
610 |
$199K |
| D7220 |
|
1,024 |
614 |
$146K |
| D7311 |
|
1,053 |
659 |
$140K |
| D7310 |
|
681 |
419 |
$72K |
| D7510 |
|
653 |
560 |
$52K |
| D7140 |
Extraction, erupted tooth or exposed root |
264 |
94 |
$18K |
| D0330 |
Panoramic radiographic image |
138 |
136 |
$6K |
| D9920 |
|
12 |
12 |
$583.21 |