BURLINGTON ORAL & MAXILLOFACIAL SURGEONS P C
NPI: 1689858110
· W BURLINGTON, IA 52655
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 12/19/2007
$162K
Total Medicaid Paid
1,456
Beneficiary Records
Provider Details
| Authorized Official | ROEWE, RAYMOND (PRESIDENT) |
| NPI Enumeration Date | 12/19/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,159 |
$93K |
| 2019 |
850 |
$66K |
| 2020 |
37 |
$3K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
328 |
105 |
$68K |
| D9222 |
|
402 |
394 |
$32K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
290 |
230 |
$19K |
| D7140 |
Extraction, erupted tooth or exposed root |
336 |
151 |
$18K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
155 |
57 |
$14K |
| D0140 |
Limited oral evaluation - problem focused |
261 |
254 |
$8K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
103 |
98 |
$2K |
| D9610 |
|
158 |
155 |
$2K |
| D9612 |
|
13 |
12 |
$0.00 |