JUST WISDOM TEETH WHEAT RIDGE
NPI: 1588909394
· WHEAT RIDGE, CO 80033
· Dentist
· NPI assigned 12/05/2012
$398K
Total Medicaid Paid
Provider Details
| Authorized Official | OLNEY, APRIL (PRACTICE RELATIONS) |
| NPI Enumeration Date | 12/05/2012 |
Related Entities
Other providers sharing the same authorized official: OLNEY, APRIL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
697 |
$70K |
| 2019 |
518 |
$54K |
| 2020 |
1,467 |
$185K |
| 2021 |
738 |
$89K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
616 |
238 |
$165K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
405 |
365 |
$93K |
| D9222 |
|
400 |
365 |
$39K |
| D0330 |
Panoramic radiographic image |
712 |
690 |
$35K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
759 |
739 |
$27K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
154 |
87 |
$24K |
| D9219 |
|
374 |
357 |
$14K |