WESTERN LAKE ERIE OMS LTD.
NPI: 1538380662
· SYLVANIA, OH 43560
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 05/02/2007
$2.15M
Total Medicaid Paid
Provider Details
| Authorized Official | SHALL, STEPHEN (PRESIDENT) |
| NPI Enumeration Date | 05/02/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
5,113 |
$428K |
| 2019 |
2,289 |
$154K |
| 2020 |
1,349 |
$82K |
| 2021 |
3,732 |
$335K |
| 2022 |
4,299 |
$498K |
| 2023 |
2,995 |
$308K |
| 2024 |
3,042 |
$345K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
3,719 |
1,252 |
$577K |
| D7140 |
Extraction, erupted tooth or exposed root |
6,175 |
1,422 |
$439K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,686 |
1,274 |
$277K |
| D7230 |
|
1,537 |
569 |
$274K |
| D0140 |
Limited oral evaluation - problem focused |
4,336 |
4,184 |
$200K |
| D9222 |
|
1,445 |
1,234 |
$184K |
| D7240 |
Removal of impacted tooth - completely bony |
497 |
146 |
$108K |
| D9612 |
|
865 |
844 |
$42K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,326 |
918 |
$37K |
| D0330 |
Panoramic radiographic image |
166 |
158 |
$12K |
| D0367 |
|
12 |
12 |
$1K |
| D1999 |
|
55 |
55 |
$0.00 |