SHENANDOAH ORAL & MAXILLOFACIAL SURGERY INC
NPI: 1972940393
· WINCHESTER, VA 22602
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 05/24/2013
$467K
Total Medicaid Paid
Provider Details
| Authorized Official | FUGATE, TARA (PRACTICE ADMINISTRATOR) |
| NPI Enumeration Date | 05/24/2013 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
425 |
$42K |
| 2020 |
367 |
$33K |
| 2021 |
1,380 |
$146K |
| 2022 |
1,025 |
$129K |
| 2023 |
1,494 |
$117K |
| 2024 |
545 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,778 |
896 |
$315K |
| D9310 |
|
1,586 |
1,574 |
$111K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
363 |
118 |
$22K |
| D0330 |
Panoramic radiographic image |
244 |
243 |
$9K |
| D9222 |
|
119 |
117 |
$7K |
| D9610 |
|
146 |
144 |
$3K |