Dental
Sundance Dental Care of Gallup
Sundance Dental Care of Gallup was paid $4.77M by Medicaid between Jan 2018 and Dec 2021, across 34 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 11% of everything it billed.
33Billing provider infoSUNDANCE DENTAL CARE OF GALLUP
GALLUP, NM 87301
GALLUP, NM 87301
33aNPI1235406927assigned 11/23/2011
33bProvider typeGeneral Practice Dentistry
28Total paid$4.77M
24GClaims133,691
24DCodes billed34
24AFirst – last monthJan 2018 – Dec 2021
Compared with peers
Next to other General Practice Dentistry providers in New Mexico
Rank by total paid#8 of 202
Median peer was paid$44K
This provider vs. median109×
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 | 33,391 | $1.23M | |
| 2019 | 37,945 | $1.32M | |
| 2020 | 28,980 | $1.06M | |
| 2021 | 33,375 | $1.16M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 11% | 14,668 | 14,528 | $508K |
| D1110 | Prophylaxis - adult | 8.0% | 8,356 | 8,284 | $384K |
| D0274 | Bitewings - four radiographic images | 7.3% | 11,869 | 11,760 | $350K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 6.9% | 4,533 | 3,111 | $330K |
| D1120 | Dental cleaning, childProphylaxis - child | 6.3% | 9,515 | 9,444 | $302K |
| D1208 | Topical application of fluoride, excluding varnish | 5.3% | 14,001 | 13,897 | $252K |
| D7140 | Extraction, erupted tooth or exposed root | 5.2% | 3,835 | 1,796 | $247K |
| D0210 | Intraoral - complete series of radiographic images | 4.7% | 3,777 | 3,743 | $224K |
| D5213 | 4.5% | 278 | 266 | $217K | |
| D0220 | Intraoral - periapical first radiographic image | 4.0% | 17,017 | 16,650 | $193K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 3.5% | 1,578 | 840 | $169K |
| D1351 | Sealant - per tooth | 3.4% | 6,926 | 1,285 | $163K |
22 more codes
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 3.1% | 1,674 | $148K |
| D0140 | Limited oral evaluation - problem focused | 2.9% | 4,801 | $140K |
| D0330 | Panoramic radiographic image | 2.9% | 2,657 | $137K |
| D5214 | 2.8% | 174 | $136K | |
| D4341 | 2.8% | 1,166 | $135K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.7% | 2,346 | $128K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.5% | 12,901 | $117K |
| D2335 | 1.8% | 676 | $88K | |
| D0120 | Dental checkup, returning patient | 1.8% | 3,727 | $85K |
| D2331 | 1.7% | 939 | $81K | |
| D1206 | Topical application of fluoride varnish | 1.6% | 4,078 | $76K |
| D2332 | <1% | 240 | $26K | |
| D2330 | <1% | 370 | $25K | |
| D7250 | <1% | 200 | $25K | |
| D7240 | Removal of impacted tooth - completely bony | <1% | 121 | $23K |
| D5110 | <1% | 24 | $18K | |
| D0272 | Bitewings - two radiographic images | <1% | 721 | $15K |
| D9239 | <1% | 82 | $9K | |
| D9243 | <1% | 145 | $8K | |
| D2940 | <1% | 177 | $8K | |
| D2394 | <1% | 38 | $4K | |
| D9610 | <1% | 81 | $2K |
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 officialSHAHEEN, BRUCE (DENTIST/OWNER)