Dental
1601 2ND Street Gallup Professional, LLC
1601 2ND Street Gallup Professional, LLC was paid $3.59M by Medicaid between Oct 2021 and Dec 2024, across 30 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 13% of everything it billed.
33Billing provider info1601 2ND STREET GALLUP PROFESSIONAL, LLC
GALLUP, NM 87301
GALLUP, NM 87301
33aNPI1386309870assigned 11/01/2021
33bProvider typeGeneral Practice Dentistry
28Total paid$3.59M
24GClaims114,615
24DCodes billed30
24AFirst – last monthOct 2021 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in New Mexico
Rank by total paid#15 of 202
Median peer was paid$44K
This provider vs. median82×
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 | 518 | $11K | |
| 2022 | 37,666 | $1.18M | |
| 2023 | 39,109 | $1.23M | |
| 2024incomplete | 37,322 | $1.17M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 13% | 13,555 | 13,275 | $475K |
| D0274 | Bitewings - four radiographic images | 10% | 12,583 | 12,287 | $371K |
| D1110 | Prophylaxis - adult | 10.0% | 7,804 | 7,638 | $357K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.8% | 3,814 | 2,750 | $281K |
| D1120 | Dental cleaning, childProphylaxis - child | 7.6% | 8,391 | 8,227 | $271K |
| D0220 | Intraoral - periapical first radiographic image | 5.2% | 16,415 | 15,910 | $186K |
| D1208 | Topical application of fluoride, excluding varnish | 5.1% | 10,120 | 9,955 | $185K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.5% | 2,931 | 2,035 | $162K |
| D0210 | Intraoral - complete series of radiographic images | 4.3% | 2,554 | 2,535 | $156K |
| D7140 | Extraction, erupted tooth or exposed root | 3.9% | 2,163 | 1,110 | $141K |
| D1206 | Topical application of fluoride varnish | 3.5% | 6,841 | 6,667 | $127K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.4% | 13,436 | 13,125 | $123K |
18 more codes
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 3.2% | 1,320 | $117K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 2.5% | 867 | $91K |
| D0140 | Limited oral evaluation - problem focused | 2.5% | 3,072 | $90K |
| D0120 | Dental checkup, returning patient | 2.3% | 3,686 | $84K |
| D2331 | 2.3% | 940 | $82K | |
| D0330 | Panoramic radiographic image | 2.1% | 1,480 | $74K |
| D5213 | 1.4% | 66 | $51K | |
| D5214 | <1% | 40 | $31K | |
| D4346 | <1% | 221 | $26K | |
| D1351 | Sealant - per tooth | <1% | 982 | $24K |
| D2332 | <1% | 174 | $18K | |
| D2335 | <1% | 135 | $16K | |
| D2330 | <1% | 214 | $14K | |
| D4341 | <1% | 109 | $12K | |
| D0272 | Bitewings - two radiographic images | <1% | 444 | $9K |
| D2940 | <1% | 178 | $8K | |
| D2394 | <1% | 46 | $5K | |
| D7250 | <1% | 34 | $5K |
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 officialGRMBOS, PETER (OWNER/DENTIST)