Clinic
Sandalwood Dental Care LLC
Sandalwood Dental Care LLC was paid $400K by Medicaid between Jan 2019 and Dec 2024, across 15 billing codes. Its largest line is D1110, Prophylaxis - adult — 33% of everything it billed.
33Billing provider infoSANDALWOOD DENTAL CARE LLC
PUEBLO, CO 81005
PUEBLO, CO 81005
33aNPI1174095624assigned 12/21/2018
33bProvider typeDental Clinic/Center
28Total paid$400K
24GClaims9,104
24DCodes billed15
24AFirst – last monthJan 2019 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Colorado
Rank by total paid#74 of 193
Median peer was paid$180K
This provider vs. median2.2×
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 | |
|---|---|---|---|
| 2019 | 1,641 | $81K | |
| 2020 | 1,409 | $52K | |
| 2021 | 1,706 | $83K | |
| 2022 | 1,670 | $62K | |
| 2023 | 1,591 | $69K | |
| 2024incomplete | 1,087 | $52K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 33% | 2,676 | 2,648 | $132K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 20% | 3,262 | 3,226 | $82K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 18% | 541 | 413 | $74K |
| D0274 | Bitewings - four radiographic images | 9.0% | 1,163 | 1,156 | $36K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 8.1% | 203 | 169 | $33K |
| D2740 | Crown - porcelain/ceramic | 4.4% | 28 | 24 | $18K |
| D0220 | Intraoral - periapical first radiographic image | 2.3% | 724 | 694 | $9K |
| D1206 | Topical application of fluoride varnish | 1.7% | 287 | 286 | $7K |
| D2394 | <1% | 14 | 12 | $3K | |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 20 | 12 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 47 | 47 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 102 | 102 | $1K |
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 officialRAGULSKY, GREG (DENTIST)