MODELEVSKY DDS PA
NPI: 1922267657
· JONESBORO, AR 72401
· Oral and Maxillofacial Surgery Clinic/Center
· NPI assigned 06/06/2008
$963K
Total Medicaid Paid
Provider Details
| Authorized Official | MODELEVSKY, TERI (OFFICE MANAGER) |
| NPI Enumeration Date | 06/06/2008 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
103 |
$191.90 |
| 2020 |
888 |
$151K |
| 2021 |
2,144 |
$368K |
| 2022 |
1,336 |
$225K |
| 2023 |
1,232 |
$219K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
2,827 |
851 |
$718K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,841 |
1,065 |
$146K |
| D9222 |
|
985 |
969 |
$88K |
| D7230 |
|
50 |
30 |
$10K |