MAINE COAST ORAL SURGERY
NPI: 1952717084
· PORTLAND, ME 04102
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 07/09/2014
$121K
Total Medicaid Paid
Provider Details
| Authorized Official | COLLETT, RUSSELL (ORAL SURGEON) |
| NPI Enumeration Date | 07/09/2014 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,163 |
$121K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
295 |
180 |
$43K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
330 |
89 |
$34K |
| D9222 |
|
187 |
179 |
$27K |
| D7240 |
Removal of impacted tooth - completely bony |
48 |
14 |
$8K |
| D0140 |
Limited oral evaluation - problem focused |
244 |
229 |
$5K |
| D7140 |
Extraction, erupted tooth or exposed root |
36 |
12 |
$3K |
| D0330 |
Panoramic radiographic image |
23 |
22 |
$946.00 |