ORAL SURGERY CENTER OF IDAHO, PLLC
NPI: 1841634581
· MERIDIAN, ID 83642
· Oral and Maxillofacial Surgery Clinic/Center
· NPI assigned 04/24/2013
$253K
Total Medicaid Paid
Provider Details
| Authorized Official | DABELL, MICHAEL (ORAL SURGEON) |
| NPI Enumeration Date | 04/24/2013 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
3,317 |
$253K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
683 |
255 |
$161K |
| D7230 |
|
258 |
117 |
$38K |
| D0140 |
Limited oral evaluation - problem focused |
562 |
557 |
$27K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
110 |
43 |
$11K |
| D9222 |
|
380 |
377 |
$6K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
826 |
379 |
$5K |
| D7220 |
|
22 |
13 |
$4K |
| D0330 |
Panoramic radiographic image |
476 |
473 |
$829.23 |