STATE OF MONTANA
NPI: 1912120817
· HELENA, MT 59620
· Oral and Maxillofacial Surgery Clinic/Center
· NPI assigned 04/10/2007
Provider Details
| Authorized Official | O'DONNELL, MICHELE (BILLING AGENT) |
| Parent Organization | STATE OF MONTANA |
| NPI Enumeration Date | 04/10/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
119 |
$26K |
| 2019 |
84 |
$16K |
| 2020 |
31 |
$2K |
| 2021 |
31 |
$3K |
| 2022 |
18 |
$17K |
| 2023 |
13 |
$9K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1025 |
Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per diem |
270 |
261 |
$65K |
| T1024 |
Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter |
26 |
18 |
$8K |