MT OMS SPECIALTY DENTAL SERVICES, PLLC
NPI: 1780378174
· BILLINGS, MT 59106
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 06/07/2023
$234K
Total Medicaid Paid
Provider Details
| Authorized Official | VIAL, CHARLOTTE (DIRECTOR OF PROVIDER) |
| Parent Organization | MT OMS SPECIALTY DENTAL SERVICES, PLLC |
| NPI Enumeration Date | 06/07/2023 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
147 |
$19K |
| 2024 |
1,509 |
$215K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
553 |
189 |
$139K |
| D9222 |
|
363 |
353 |
$40K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
393 |
316 |
$37K |
| D0140 |
Limited oral evaluation - problem focused |
315 |
308 |
$13K |
| D7230 |
|
20 |
12 |
$4K |
| D9310 |
|
12 |
12 |
$735.33 |