SULLIVAN, TIWANA, & RITTO ORAL & MAXILLOFACIAL SURGERY PARTNERSHIP
NPI: 1952401796
· OKLAHOMA CITY, OK 73104
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 09/22/2006
$1.67M
Total Medicaid Paid
Provider Details
| Authorized Official | PAGE, AMBER (PRACTICE MANAGER) |
| NPI Enumeration Date | 09/22/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
572 |
$94K |
| 2022 |
3,192 |
$479K |
| 2023 |
3,592 |
$797K |
| 2024 |
2,603 |
$301K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
2,247 |
669 |
$469K |
| D7947 |
|
114 |
114 |
$433K |
| D7943 |
|
61 |
61 |
$264K |
| 21085 |
|
172 |
172 |
$100K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
906 |
896 |
$72K |
| 70486 |
|
1,305 |
1,303 |
$65K |
| D7950 |
|
36 |
36 |
$47K |
| D9222 |
|
516 |
493 |
$40K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
461 |
438 |
$38K |
| D9310 |
|
724 |
700 |
$34K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
524 |
524 |
$33K |
| 70355 |
|
1,206 |
1,206 |
$19K |
| 20670 |
|
49 |
49 |
$15K |
| D9610 |
|
472 |
447 |
$14K |
| 70350 |
|
852 |
852 |
$12K |
| D0470 |
|
175 |
175 |
$7K |
| D7140 |
Extraction, erupted tooth or exposed root |
81 |
25 |
$5K |
| 99215 |
Prolong outpt/office vis |
26 |
26 |
$4K |
| D0330 |
Panoramic radiographic image |
32 |
25 |
$2K |