GARDENDALE ORAL SURGERY, P.C.
NPI: 1336632561
· GARDENDALE, AL 35071
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 06/12/2018
$464K
Total Medicaid Paid
Provider Details
| Authorized Official | LACKEY, JUSTIN (FRONT OFFICE) |
| NPI Enumeration Date | 06/12/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,846 |
$269K |
| 2019 |
1,876 |
$195K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7230 |
|
1,335 |
356 |
$214K |
| D7240 |
Removal of impacted tooth - completely bony |
702 |
185 |
$106K |
| D9222 |
|
610 |
566 |
$60K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
668 |
568 |
$59K |
| D0140 |
Limited oral evaluation - problem focused |
724 |
616 |
$16K |
| D0330 |
Panoramic radiographic image |
516 |
458 |
$9K |
| D9612 |
|
167 |
153 |
$0.00 |