SOUTH CENTRAL ORAL & MAXILLOFACIAL SURGERY, LLC
NPI: 1760461339
· BLOOMINGTON, IN 47401
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 01/12/2006
$1.77M
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,468 |
$13K |
| 2019 |
2,613 |
$340K |
| 2020 |
2,505 |
$276K |
| 2021 |
2,483 |
$307K |
| 2022 |
2,589 |
$324K |
| 2023 |
2,384 |
$323K |
| 2024 |
1,452 |
$192K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
2,078 |
700 |
$575K |
| D7140 |
Extraction, erupted tooth or exposed root |
5,237 |
1,880 |
$450K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,725 |
810 |
$288K |
| D9243 |
|
2,443 |
1,388 |
$201K |
| D0330 |
Panoramic radiographic image |
1,687 |
1,625 |
$109K |
| D9239 |
|
1,456 |
1,370 |
$105K |
| D0140 |
Limited oral evaluation - problem focused |
756 |
730 |
$32K |
| D7250 |
|
61 |
24 |
$12K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
51 |
49 |
$1K |