NORTHERN MONTANA ORAL SURGERY
NPI: 1497394811
· GREAT FALLS, MT 59405
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 01/02/2020
$109K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
1,094 |
$109K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
281 |
112 |
$34K |
| D7240 |
Removal of impacted tooth - completely bony |
80 |
29 |
$20K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
142 |
139 |
$17K |
| D9310 |
|
270 |
266 |
$16K |
| D9222 |
|
176 |
171 |
$15K |
| D0330 |
Panoramic radiographic image |
74 |
73 |
$4K |
| D7140 |
Extraction, erupted tooth or exposed root |
26 |
14 |
$2K |
| D9630 |
|
45 |
44 |
$748.41 |