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UPSTATE ORAL & MAXILLOFACIAL SURGERY & DENTAL IMPLANT CENTER, P.A.
UPSTATE ORAL & MAXILLOFACIAL SURGERY & DENTAL IMPLANT CENTER, P.A.
NPI: 1770707887
· EASLEY, SC 29640
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 04/12/2007
$1.58M
Total Medicaid Paid
Provider Details
| Authorized Official | JOUDEH, SAMER (OWNER) |
| NPI Enumeration Date | 04/12/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,875 |
$400K |
| 2019 |
3,017 |
$306K |
| 2020 |
2,912 |
$281K |
| 2021 |
2,756 |
$277K |
| 2022 |
2,386 |
$241K |
| 2023 |
1,155 |
$74K |
| 2024 |
19 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,549 |
1,214 |
$343K |
| D7240 |
Removal of impacted tooth - completely bony |
1,169 |
392 |
$319K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,722 |
2,718 |
$244K |
| D9222 |
|
2,720 |
2,718 |
$242K |
| D7230 |
|
651 |
294 |
$148K |
| D0140 |
Limited oral evaluation - problem focused |
3,806 |
3,806 |
$142K |
| D9310 |
|
1,486 |
1,486 |
$91K |
| D0330 |
Panoramic radiographic image |
910 |
910 |
$44K |
| D7140 |
Extraction, erupted tooth or exposed root |
107 |
30 |
$8K |