Sjostrom, Danen

Sjostrom, Danen was paid $16K by Medicaid between Jan 2018 and Aug 2018, across 11 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 33% of everything it billed.

33Billing provider infoSJOSTROM, DANEN
ALBUQUERQUE, NM 87109

33aNPI1427379130assigned 06/16/2010

33bProvider typePediatric Dentist

28Total paid$16K

24GClaims623

24DCodes billed11

24AFirst – last monthJan 2018 – Aug 2018

Compared with peers

Next to other Pediatric Dentist providers in New Mexico

Rank by total paid#33 of 44

Median peer was paid$240K

This provider vs. median0.1×

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	623	$16K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D2930	Prefabricated stainless steel crown - primary tooth	33%	46	12	$5K
D1120	Dental cleaning, childProphylaxis - child	16%	100	97	$3K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	16%	130	127	$2K
D1208	Topical application of fluoride, excluding varnish	14%	148	144	$2K
D9420		5.0%	12	12	$780.67
D0272	Bitewings - two radiographic images	3.9%	42	40	$609.15
D0220	Intraoral - periapical first radiographic image	3.5%	67	63	$556.92
D0150	Comprehensive oral evaluation - new or established patient	2.8%	15	14	$436.54
D0230	Intraoral - periapical each additional radiographic image	2.4%	21	17	$383.68
D0140	Limited oral evaluation - problem focused	2.0%	13	12	$312.07
D0240		1.8%	29	29	$283.92

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.