Dental
Wisdom Teeth Only
Wisdom Teeth Only was paid $6K by Medicaid between Aug 2020 and Jun 2022, across 1 billing code. Its largest line is 00170, Anesthesia for intraoral procedures, including biopsy — 100% of everything it billed.
33Billing provider infoWISDOM TEETH ONLY
PROVO, UT 84604
PROVO, UT 84604
33aNPI1528518909assigned 10/10/2016
33bProvider typeDentist
28Total paid$6K
24GClaims63
24DCodes billed1
24AFirst – last monthAug 2020 – Jun 2022
Compared with peers
Next to other Dentist providers in Utah
Rank by total paid#100 of 136
Median peer was paid$35K
This provider vs. median0.2×
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 | |
|---|---|---|---|
| 2020 | 26 | $3K | |
| 2021 | 20 | $1K | |
| 2022 | 17 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 00170 | Anesthesia for intraoral procedures, including biopsy | 100% | 63 | 51 | $6K |
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 officialGARCIA, ELIZABETH (OFFICE MANAGER)
| Provider | Location | Paid |
|---|---|---|
| A Royal Behavioral Agency LLC | Las Vegas, NV | $3.14M |
| Blooming Mind Behavioral Services LLC | Colton, CA | $380K |
| Elizabeth Garcia, DDS Prof. Dental Corp. | South Gate, CA | $25K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.