Clinic
Summit Family Dental of Bernalillo, LLC
Summit Family Dental of Bernalillo, LLC was paid $17K by Medicaid between Jul 2021 and Jun 2024, across 9 billing codes. Its largest line is D1110, Prophylaxis - adult — 26% of everything it billed.
33Billing provider infoSUMMIT FAMILY DENTAL OF BERNALILLO, LLC
RIO RANCHO, NM 87144
RIO RANCHO, NM 87144
33aNPI1346833878assigned 02/16/2021
33bProvider typeDental Clinic/Center
28Total paid$17K
24GClaims644
24DCodes billed9
24AFirst – last monthJul 2021 – Jun 2024
Compared with peers
Next to other Dental Clinic/Center providers in New Mexico
Rank by total paid#37 of 41
Median peer was paid$351K
This provider vs. median0.0×
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 | |
|---|---|---|---|
| 2021 | 227 | $7K | |
| 2022 | 314 | $8K | |
| 2023 | 78 | $2K | |
| 2024incomplete | 25 | $266.77 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 26% | 122 | 122 | $4K |
| D0274 | Bitewings - four radiographic images | 19% | 113 | 113 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | 14% | 66 | 66 | $2K |
| D1206 | Topical application of fluoride varnish | 12% | 109 | 109 | $2K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 57 | 57 | $2K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.3% | 57 | 56 | $1K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.8% | 20 | 12 | $989.56 |
| D0220 | Intraoral - periapical first radiographic image | 3.5% | 59 | 59 | $588.75 |
| D0230 | Intraoral - periapical each additional radiographic image | 2.1% | 41 | 41 | $354.33 |
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 officialHODGES, LISA (OPERATIONS DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Beckland Dental Kids of Farmington LLC | Farmington, NM | $4.29M |
| Summit Family Dental of Farmington, LLC | Farmington, NM | $812K |
| Summit Family Dental of Cortez, PLLC | Cortez, CO | $302K |
| Sundance Orthodontics LLC | Farmington, NM | $192K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.