Dental
Cheyenne Mountain Oral Surgery PC
Cheyenne Mountain Oral Surgery PC was paid $15K by Medicaid between Jun 2019 and Jun 2022, across 6 billing codes. Its largest line is D9310, — 36% of everything it billed.
33Billing provider infoCHEYENNE MOUNTAIN ORAL SURGERY PC
COLORADO SPRINGS, CO 80906
COLORADO SPRINGS, CO 80906
33aNPI1689167280assigned 06/08/2018
33bProvider typeOral and Maxillofacial Surgery (Dentist)
28Total paid$15K
24GClaims254
24DCodes billed6
24AFirst – last monthJun 2019 – Jun 2022
Compared with peers
Next to other Oral and Maxillofacial Surgery (Dentist) providers in Colorado
Rank by total paid#45 of 59
Median peer was paid$152K
This provider vs. median0.1×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2019 | 60 | $2K | |
| 2020 | 57 | $2K | |
| 2021 | 125 | $10K | |
| 2022 | 12 | $840.24 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D9310 | 36% | 132 | 130 | $5K | |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 23% | 24 | 14 | $3K |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | 14% | 13 | 12 | $2K |
| D0140 | Limited oral evaluation - problem focused | 14% | 60 | 53 | $2K |
| D9222 | 7.6% | 13 | 12 | $1K | |
| D0160 | 5.7% | 12 | 12 | $840.24 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialJENSEN, DAYNE (OWNER)
| Provider | Location | 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 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.