PREMIER ORAL SURGERY AND IMPLANTOLOGY CENTER LLC
NPI: 1952898025
· STRATFORD, CT 06614
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 04/15/2018
$6.72M
Total Medicaid Paid
Provider Details
| Authorized Official | BANGIYEV, SIMON (PRESIDENT) |
| NPI Enumeration Date | 04/15/2018 |
Related Entities
Other providers sharing the same authorized official: BANGIYEV, SIMON
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,611 |
$128K |
| 2019 |
5,180 |
$467K |
| 2020 |
4,277 |
$388K |
| 2021 |
10,667 |
$1.12M |
| 2022 |
11,963 |
$1.40M |
| 2023 |
10,789 |
$1.52M |
| 2024 |
13,377 |
$1.70M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
19,353 |
7,443 |
$2.11M |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
5,483 |
5,041 |
$1.60M |
| D7240 |
Removal of impacted tooth - completely bony |
3,280 |
1,230 |
$924K |
| D7230 |
|
3,738 |
1,874 |
$750K |
| D7250 |
|
2,319 |
904 |
$351K |
| D0330 |
Panoramic radiographic image |
7,033 |
6,442 |
$333K |
| D0140 |
Limited oral evaluation - problem focused |
9,508 |
8,828 |
$262K |
| D9222 |
|
1,868 |
1,788 |
$160K |
| D7220 |
|
913 |
589 |
$134K |
| D9310 |
|
4,285 |
3,955 |
$84K |
| D9613 |
|
21 |
19 |
$4K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
47 |
45 |
$2K |
| D0364 |
|
16 |
12 |
$765.00 |