IDAHO CENTER FOR ORAL AND FACIAL SURGERY
NPI: 1558675298
· POCATELLO, ID 83201
· Oral and Maxillofacial Surgery Clinic/Center
· NPI assigned 08/05/2010
$117K
Total Medicaid Paid
Provider Details
| Authorized Official | DABELL, JEFFREY (SURGEON) |
| NPI Enumeration Date | 08/05/2010 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
677 |
$27K |
| 2019 |
850 |
$37K |
| 2020 |
585 |
$16K |
| 2021 |
516 |
$16K |
| 2022 |
373 |
$7K |
| 2023 |
234 |
$4K |
| 2024 |
285 |
$10K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
266 |
96 |
$48K |
| D0330 |
Panoramic radiographic image |
877 |
876 |
$36K |
| D0140 |
Limited oral evaluation - problem focused |
1,737 |
1,731 |
$15K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
108 |
55 |
$14K |
| D9310 |
|
13 |
13 |
$2K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
316 |
269 |
$2K |
| D9222 |
|
203 |
203 |
$511.32 |