Clinic
Cottonwood Mall Dental Practice, LLC
Cottonwood Mall Dental Practice, LLC was paid $239K by Medicaid between Jan 2018 and Dec 2024, across 14 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 25% of everything it billed.
33Billing provider infoCOTTONWOOD MALL DENTAL PRACTICE, LLC
ALBUQUERQUE, NM 87114
ALBUQUERQUE, NM 87114
33aNPI1043487119assigned 05/08/2008
33bProvider typeDental Clinic/Center
28Total paid$239K
24GClaims7,464
24DCodes billed14
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in New Mexico
Rank by total paid#27 of 41
Median peer was paid$351K
This provider vs. median0.7×
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 | 2,056 | $63K | |
| 2019 | 1,404 | $52K | |
| 2020 | 693 | $22K | |
| 2021 | 629 | $20K | |
| 2022 | 946 | $30K | |
| 2023 | 1,003 | $32K | |
| 2024incomplete | 733 | $21K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 25% | 1,748 | 1,747 | $61K |
| D0274 | Bitewings - four radiographic images | 25% | 2,056 | 2,054 | $59K |
| D1110 | Prophylaxis - adult | 22% | 1,181 | 1,181 | $53K |
| D1208 | Topical application of fluoride, excluding varnish | 9.1% | 1,216 | 1,216 | $22K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 6.3% | 206 | 136 | $15K |
| D1120 | Dental cleaning, childProphylaxis - child | 3.4% | 280 | 279 | $8K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 2.3% | 61 | 25 | $5K |
| D0330 | Panoramic radiographic image | 2.2% | 134 | 134 | $5K |
| D0220 | Intraoral - periapical first radiographic image | 1.3% | 289 | 287 | $3K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.0% | 45 | 36 | $2K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 1.0% | 109 | 109 | $2K |
| D0140 | Limited oral evaluation - problem focused | <1% | 37 | 36 | $1K |
2 more codes
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 officialSAPP, WILLIAM (PRESIDENT)