LA FAMILIA MEDICAL CENTER
NPI: 1336437672
· SANTA FE, NM 87508
· Dentist
· NPI assigned 07/20/2011
$551K
Total Medicaid Paid
Provider Details
| Authorized Official | VAN PELT, BRANDON (CEO) |
| Parent Organization | LA FAMILIA MEDICAL CENTER |
| NPI Enumeration Date | 07/20/2011 |
Related Entities
Other providers sharing the same authorized official: VAN PELT, BRANDON
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
389 |
$80K |
| 2023 |
1,385 |
$273K |
| 2024 |
977 |
$198K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
2,667 |
2,451 |
$551K |
| D0230 |
Intraoral - periapical each additional radiographic image |
23 |
15 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
17 |
17 |
$0.00 |
| D1110 |
Prophylaxis - adult |
26 |
26 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
18 |
18 |
$0.00 |