Dental
Santa Teresa Cosmetic and Family Dentistry LLC
Santa Teresa Cosmetic and Family Dentistry LLC was paid $291K by Medicaid between May 2019 and Jan 2022, across 18 billing codes. Its largest line is D4346, — 21% of everything it billed.
33Billing provider infoSANTA TERESA COSMETIC AND FAMILY DENTISTRY LLC
SANTA TERESA, NM 88008
SANTA TERESA, NM 88008
33aNPI1295215713assigned 08/14/2018
33bProvider typeGeneral Practice Dentistry
28Total paid$291K
24GClaims7,690
24DCodes billed18
24AFirst – last monthMay 2019 – Jan 2022
Compared with peers
Next to other General Practice Dentistry providers in New Mexico
Rank by total paid#53 of 202
Median peer was paid$44K
This provider vs. median6.6×
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 | 2,131 | $94K | |
| 2020 | 2,493 | $94K | |
| 2021 | 3,015 | $101K | |
| 2022 | 51 | $820.80 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D4346 | 21% | 510 | 510 | $61K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 15% | 602 | 248 | $45K |
| D0150 | Comprehensive oral evaluation - new or established patient | 15% | 1,203 | 1,202 | $42K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 12% | 384 | 165 | $34K |
| D0274 | Bitewings - four radiographic images | 8.6% | 844 | 844 | $25K |
| D1120 | Dental cleaning, childProphylaxis - child | 6.4% | 586 | 585 | $19K |
| D0220 | Intraoral - periapical first radiographic image | 4.7% | 1,200 | 1,196 | $14K |
| D0210 | Intraoral - complete series of radiographic images | 4.1% | 215 | 204 | $12K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.5% | 1,095 | 1,059 | $10K |
| D1206 | Topical application of fluoride varnish | 2.3% | 367 | 367 | $7K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.2% | 116 | 52 | $6K |
| D1110 | Prophylaxis - adult | 2.0% | 128 | 128 | $6K |
6 more codes
| D1208 | Topical application of fluoride, excluding varnish | 1.3% | 208 | $4K |
| D0120 | Dental checkup, returning patient | 1.2% | 156 | $4K |
| D9110 | <1% | 33 | $2K | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 16 | $413.48 |
| D0140 | Limited oral evaluation - problem focused | <1% | 14 | $383.78 |
| D0330 | Panoramic radiographic image | <1% | 13 | $150.31 |
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 officialOUSHY EISSA, NOHA (DENTIST)