Dental
Professional Dental Care of Northern New Mexico I Professional
Professional Dental Care of Northern New Mexico I Professional was paid $62K by Medicaid between Jun 2020 and Mar 2021, across 14 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 17% of everything it billed.
33Billing provider infoPROFESSIONAL DENTAL CARE OF NORTHERN NEW MEXICO I PROFESSIONAL
SANTA FE, NM 87505
SANTA FE, NM 87505
33aNPI1457998106assigned 12/02/2019
33bProvider typeGeneral Practice Dentistry
28Total paid$62K
24GClaims1,600
24DCodes billed14
24AFirst – last monthJun 2020 – Mar 2021
Compared with peers
Next to other General Practice Dentistry providers in New Mexico
Rank by total paid#93 of 202
Median peer was paid$44K
This provider vs. median1.4×
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 | |
|---|---|---|---|
| 2020 | 1,118 | $44K | |
| 2021 | 482 | $18K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 17% | 150 | 84 | $11K |
| D0150 | Comprehensive oral evaluation - new or established patient | 16% | 293 | 293 | $10K |
| D1110 | Prophylaxis - adult | 13% | 193 | 193 | $8K |
| D4346 | 13% | 69 | 69 | $8K | |
| D0274 | Bitewings - four radiographic images | 13% | 272 | 272 | $8K |
| D0210 | Intraoral - complete series of radiographic images | 9.3% | 101 | 97 | $6K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.7% | 58 | 30 | $3K |
| D1208 | Topical application of fluoride, excluding varnish | 4.0% | 136 | 136 | $2K |
| D1120 | Dental cleaning, childProphylaxis - child | 3.5% | 69 | 69 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 3.0% | 167 | 166 | $2K |
| D0140 | Limited oral evaluation - problem focused | 1.3% | 28 | 28 | $832.78 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 38 | 31 | $498.19 |
2 more codes
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 officialLACOURT, FRED (CHIEF DENTAL OFFICER)
Parent organizationPROFESSIONAL DENTAL CARE PLLC