Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › CO › COLORADO SPRINGS › CHEYENNE MOUNTAIN ORAL SURGERY PC

CHEYENNE MOUNTAIN ORAL SURGERY PC

NPI: 1689167280 · COLORADO SPRINGS, CO 80906 · Oral and Maxillofacial Surgery (Dentist) · NPI assigned 06/08/2018

$15K
Total Medicaid Paid
254
Total Claims
233
Beneficiaries
6
Codes Billed
2019-06
First Month
2022-06
Last Month

Provider Details

Authorized OfficialJENSEN, DAYNE (OWNER)
NPI Enumeration Date06/08/2018

Related Entities

Other providers sharing the same authorized official: JENSEN, DAYNE

ProviderCityStateTotal Paid
YUMA SONOMA ORAL SURGERY, P.C. YUMA AZ $450K
ALBUQUERQUE ORAL SURGERY, P.C. ALBUQUERQUE NM $4K
SJ ORAL SURGERY PC SOUTH JORDAN UT $2K
GILBERT SONOMA ORAL SURGERY, P.C. GILBERT AZ $2K
ST. GEORGE RED ROCKS PC ST GEORGE UT $2K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 60 $2K
2020 57 $2K
2021 125 $10K
2022 12 $840.24

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D9310 132 130 $5K
D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth 24 14 $3K
D9223 Deep sedation/general anesthesia - each subsequent 15 minute increment 13 12 $2K
D0140 Limited oral evaluation - problem focused 60 53 $2K
D9222 13 12 $1K
D0160 12 12 $840.24