HOUSTON WISDOM TEETH, PLLC
NPI: 1992417117
· PEARLAND, TX 77584
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 12/19/2022
$338K
Total Medicaid Paid
Provider Details
| Authorized Official | HILTON, BENJAMIN (MANAGING MEMBER) |
| NPI Enumeration Date | 12/19/2022 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
173 |
$14K |
| 2024 |
3,119 |
$324K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
954 |
306 |
$238K |
| D0330 |
Panoramic radiographic image |
884 |
867 |
$47K |
| D9222 |
|
376 |
360 |
$19K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
409 |
264 |
$15K |
| D0140 |
Limited oral evaluation - problem focused |
524 |
505 |
$9K |
| D7230 |
|
48 |
26 |
$8K |
| D9239 |
|
21 |
21 |
$1K |
| D9243 |
|
24 |
17 |
$1K |
| D9610 |
|
52 |
47 |
$645.12 |