KENTUCKIANA ORAL & MAXILLOFACIAL SURGERY ASSOC PSC
NPI: 1396737011
· LOUISVILLE, KY 40205
· Dentist
· NPI assigned 08/18/2005
$1.10M
Total Medicaid Paid
Provider Details
| Authorized Official | WALTERS, NATHAN (PRESIDENT) |
| NPI Enumeration Date | 08/18/2005 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
91 |
$2K |
| 2019 |
517 |
$43K |
| 2020 |
1,035 |
$89K |
| 2021 |
1,111 |
$121K |
| 2022 |
550 |
$23K |
| 2023 |
4,114 |
$271K |
| 2024 |
5,863 |
$548K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
2,084 |
624 |
$388K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,503 |
584 |
$201K |
| D0330 |
Panoramic radiographic image |
2,407 |
2,332 |
$146K |
| D0140 |
Limited oral evaluation - problem focused |
3,124 |
2,994 |
$127K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,818 |
827 |
$114K |
| D9222 |
|
943 |
827 |
$62K |
| D7230 |
|
230 |
93 |
$26K |
| D9610 |
|
830 |
726 |
$17K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
310 |
300 |
$13K |
| D7220 |
|
32 |
16 |
$4K |