FARMINGTON ORAL & FACIAL SURGERY P A

NPI: 1437447109 · FARMINGTON, ME 04938 · Oral and Maxillofacial Surgery (Dentist) · NPI assigned 07/15/2011

$1.22M

Total Medicaid Paid

12,964

Total Claims

8,292

Beneficiaries

Codes Billed

2018-01

First Month

2020-03

Last Month

Provider Details

Authorized Official	ELLIS, JOHN (PRESIDENT)
NPI Enumeration Date	07/15/2011

Other providers sharing the same authorized official: ELLIS, JOHN

Provider	City	State	Total Paid
GREATER BALTIMORE MEDICAL CENTER, INC.	BALTIMORE	MD	$9.39M
ALLIANCE URGENT CARE, INC	HEMET	CA	$1.05M
GREATER BALTIMORE MEDICAL CENTER, INC.	BALTIMORE	MD	$792K
DR JOHN P ELLIS CLINIC PODIATRY LLC	FAIRVIEW PARK	OH	$241K
BLAIR AND ELLIS P.A.	EL PASO	TX	$52K
NORTHEASTERN PENNSYLVANIA CARDIOLOGY ASSOCIATES LLP	PLAINS	PA	$37K
EKG ASSOCIATES OF WYOMING VALLEY LLP	WILKES BARRE	PA	$17K

Code	Description	Claims	Beneficiaries	Total Paid
D7140	Extraction, erupted tooth or exposed root	2,840	507	$252K
D7240	Removal of impacted tooth - completely bony	1,237	419	$222K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth	1,954	912	$208K
D9223	Deep sedation/general anesthesia - each subsequent 15 minute increment	1,156	1,128	$177K
D9222		1,149	1,132	$168K
D0330	Panoramic radiographic image	2,028	1,976	$84K
D7250		546	210	$70K
D0140	Limited oral evaluation - problem focused	1,802	1,762	$35K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	252	246	$5K