MCLEAN ORAL & MAXILLOFACIAL SURGERY
NPI: 1760673214
· MC LEAN, VA 22101
· Exclusive Provider Organization
· NPI assigned 08/08/2007
Provider Details
| Authorized Official | FORETICH, ERIC (OWNER) |
| NPI Enumeration Date | 08/08/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
264 |
$24K |
| 2023 |
178 |
$12K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9310 |
|
200 |
200 |
$17K |
| D0330 |
Panoramic radiographic image |
131 |
131 |
$8K |
| D7240 |
Removal of impacted tooth - completely bony |
28 |
13 |
$7K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
58 |
13 |
$3K |
| D9222 |
|
13 |
13 |
$748.80 |
| D9610 |
|
12 |
12 |
$206.64 |