THIRD COAST ORAL & MAXILLOFACIAL SURGERY
NPI: 1902551351
· BYRON CENTER, MI 49315
· Oral and Maxillofacial Surgery Clinic/Center
· NPI assigned 02/15/2022
$613K
Total Medicaid Paid
Provider Details
| Authorized Official | SCHOTT, ANNIKA (FINANCIAL COORDINATOR) |
| NPI Enumeration Date | 02/15/2022 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
1,311 |
$118K |
| 2023 |
2,157 |
$224K |
| 2024 |
2,567 |
$270K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
1,363 |
454 |
$303K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,247 |
706 |
$129K |
| D9310 |
|
1,172 |
1,172 |
$87K |
| D9222 |
|
712 |
707 |
$73K |
| D0330 |
Panoramic radiographic image |
381 |
380 |
$16K |
| D7230 |
|
22 |
12 |
$5K |
| D7921 |
|
434 |
430 |
$165.00 |
| D9612 |
|
704 |
700 |
$88.28 |