PETERSON, GILMAN
NPI: 1871756924
· WINCHESTER, KY 40391
· Dentist
· NPI assigned 07/09/2008
$101K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
67 |
$4K |
| 2022 |
1,054 |
$96K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
210 |
70 |
$41K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
204 |
61 |
$18K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
176 |
112 |
$14K |
| D9222 |
|
109 |
109 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
158 |
156 |
$8K |
| D0330 |
Panoramic radiographic image |
117 |
115 |
$4K |
| D7230 |
|
19 |
12 |
$3K |
| D9610 |
|
67 |
67 |
$3K |
| D9986 |
|
61 |
59 |
$0.00 |