AMBIANCE SURGICAL ARTS CENTER
NPI: 1437703535
· MIAMI, FL 33183
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 07/26/2019
$103K
Total Medicaid Paid
1,328
Beneficiary Records
Provider Details
| Authorized Official | HINES, JERRI (OWNER) |
| NPI Enumeration Date | 07/26/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
295 |
$10K |
| 2023 |
987 |
$82K |
| 2024 |
225 |
$11K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
183 |
118 |
$51K |
| D9310 |
|
549 |
523 |
$46K |
| D0330 |
Panoramic radiographic image |
573 |
543 |
$4K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
38 |
14 |
$847.68 |
| D7240 |
Removal of impacted tooth - completely bony |
27 |
12 |
$704.00 |
| D9222 |
|
137 |
118 |
$87.00 |