JOHNSON CITY ORAL AND MAXILLOFACIAL SURGERY, LLC
NPI: 1720601230
· JOHNSON CITY, TN 37604
· Oral & Maxillofacial Surgery (D.M.D.)
· NPI assigned 05/19/2020
$711K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
681 |
$59K |
| 2021 |
1,228 |
$84K |
| 2022 |
1,074 |
$53K |
| 2023 |
2,787 |
$244K |
| 2024 |
2,406 |
$271K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
1,556 |
471 |
$362K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,270 |
1,018 |
$173K |
| D9222 |
|
1,071 |
1,017 |
$89K |
| D0140 |
Limited oral evaluation - problem focused |
1,571 |
1,514 |
$35K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
207 |
80 |
$27K |
| D0330 |
Panoramic radiographic image |
1,471 |
1,418 |
$23K |
| D7140 |
Extraction, erupted tooth or exposed root |
30 |
12 |
$2K |