TENNESSEE MAXILLOFACIAL SURGERY, PLLC
NPI: 1275211914
· KNOXVILLE, TN 37920
· Oral & Maxillofacial Surgery (D.M.D.)
· NPI assigned 07/11/2023
$972.52
Total Medicaid Paid
Provider Details
| Authorized Official | BURGESS, CAROL (PROVIDER ENROLLMENT TEAM LEAD) |
| NPI Enumeration Date | 07/11/2023 |
Related Entities
Other providers sharing the same authorized official: BURGESS, CAROL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
33 |
$972.52 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
33 |
27 |
$972.52 |