Dental
Charlottesville Oral Surgery and Dental Implant Center, LLC
Charlottesville Oral Surgery and Dental Implant Center, LLC was paid $204K by Medicaid between Mar 2018 and Aug 2024, across 7 billing codes. Its largest line is D7240, Removal of impacted tooth - completely bony — 58% of everything it billed.
33Billing provider infoCHARLOTTESVILLE ORAL SURGERY AND DENTAL IMPLANT CENTER, LLC
CHARLOTTESVILLE, VA 22911
CHARLOTTESVILLE, VA 22911
33aNPI1972740454assigned 01/20/2009
33bProvider typeOral and Maxillofacial Surgery (Dentist)
28Total paid$204K
24GClaims3,124
24DCodes billed7
24AFirst – last monthMar 2018 – Aug 2024
Compared with peers
Next to other Oral and Maxillofacial Surgery (Dentist) providers in Virginia
Rank by total paid#26 of 70
Median peer was paid$87K
This provider vs. median2.4×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 25 | $620.75 | |
| 2019 | 81 | $2K | |
| 2020 | 60 | $3K | |
| 2021 | 82 | $4K | |
| 2022 | 848 | $97K | |
| 2023 | 1,674 | $98K | |
| 2024incomplete | 354 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D7240 | Removal of impacted tooth - completely bony | 58% | 568 | 183 | $119K |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | 22% | 967 | 350 | $45K |
| D9222 | 8.0% | 359 | 350 | $16K | |
| D0140 | Limited oral evaluation - problem focused | 6.7% | 766 | 759 | $14K |
| D9610 | 2.5% | 344 | 335 | $5K | |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 2.4% | 33 | 13 | $5K |
| D0330 | Panoramic radiographic image | <1% | 87 | 87 | $809.85 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialIBANEZ, CARLOS (PRESIDENT)