Dental
Pediatric and Special Care Dentistry
Pediatric and Special Care Dentistry was paid $56K by Medicaid between Jul 2024 and Nov 2024, across 13 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 19% of everything it billed.
33Billing provider infoPEDIATRIC AND SPECIAL CARE DENTISTRY
ALBUQUERQUE, NM 87109
ALBUQUERQUE, NM 87109
33aNPI1437427929assigned 12/12/2011
33bProvider typePediatric Dentist
28Total paid$56K
24GClaims1,718
24DCodes billed13
24AFirst – last monthJul 2024 – Nov 2024
Compared with peers
Next to other Pediatric Dentist providers in New Mexico
Rank by total paid#29 of 44
Median peer was paid$240K
This provider vs. median0.2×
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 | |
|---|---|---|---|
| 2024incomplete | 1,718 | $56K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 19% | 332 | 320 | $11K |
| D0330 | Panoramic radiographic image | 18% | 198 | 195 | $10K |
| D7140 | Extraction, erupted tooth or exposed root | 13% | 110 | 38 | $7K |
| D1120 | Dental cleaning, childProphylaxis - child | 13% | 256 | 244 | $7K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 9.0% | 99 | 56 | $5K |
| D0274 | Bitewings - four radiographic images | 7.9% | 198 | 188 | $4K |
| D1208 | Topical application of fluoride, excluding varnish | 5.5% | 190 | 178 | $3K |
| D1206 | Topical application of fluoride varnish | 5.3% | 167 | 163 | $3K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 4.5% | 31 | 14 | $2K |
| D1351 | Sealant - per tooth | 1.5% | 38 | 13 | $848.88 |
| D0210 | Intraoral - complete series of radiographic images | 1.5% | 15 | 14 | $841.96 |
| D0220 | Intraoral - periapical first radiographic image | 1.2% | 70 | 65 | $673.56 |
1 more codes
| D9248 | <1% | 14 | $334.23 |
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 officialBELFON, ROBERT (PEDIATRIC DENTIST)