SHELTON ORAL SURGERY & IMPLANT CENTER, PC
NPI: 1649834243
· IRVINGTON, NJ 07111
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 04/29/2019
$464K
Total Medicaid Paid
Provider Details
| Authorized Official | KIM, ANDREW (PRESIDENT) |
| NPI Enumeration Date | 04/29/2019 |
Related Entities
Other providers sharing the same authorized official: KIM, ANDREW
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
997 |
$13K |
| 2021 |
2,756 |
$24K |
| 2022 |
3,112 |
$76K |
| 2023 |
3,941 |
$211K |
| 2024 |
2,435 |
$139K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
3,853 |
1,300 |
$216K |
| D7310 |
|
1,354 |
680 |
$127K |
| D0330 |
Panoramic radiographic image |
2,731 |
2,681 |
$46K |
| D9310 |
|
1,105 |
1,079 |
$33K |
| D0140 |
Limited oral evaluation - problem focused |
943 |
912 |
$26K |
| D7230 |
|
89 |
73 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,642 |
1,617 |
$3K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
26 |
24 |
$2K |
| D9222 |
|
24 |
24 |
$720.00 |
| D0170 |
|
388 |
379 |
$548.00 |
| D7261 |
|
12 |
12 |
$70.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
1,074 |
381 |
$0.00 |