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FORT WAYNE ORAL MAXILLOFACIAL SURGERY & IMPLANT CENTER, LLC
FORT WAYNE ORAL MAXILLOFACIAL SURGERY & IMPLANT CENTER, LLC
NPI: 1649347832
· FORT WAYNE, IN 46825
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 11/30/2006
$649K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,809 |
$45K |
| 2019 |
2,075 |
$217K |
| 2020 |
1,102 |
$118K |
| 2021 |
2,031 |
$268K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,350 |
562 |
$312K |
| D7240 |
Removal of impacted tooth - completely bony |
640 |
213 |
$179K |
| D0160 |
|
1,542 |
1,344 |
$62K |
| D9243 |
|
461 |
332 |
$25K |
| D7230 |
|
93 |
43 |
$21K |
| D9239 |
|
370 |
331 |
$18K |
| D9222 |
|
195 |
167 |
$12K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
181 |
150 |
$11K |
| D9630 |
|
523 |
219 |
$4K |
| D0330 |
Panoramic radiographic image |
83 |
73 |
$3K |
| D9610 |
|
579 |
486 |
$0.00 |