Dental
Laredo Covenant Dental, P.A.
Laredo Covenant Dental, P.A. was paid $6K by Medicaid between Dec 2020 and Aug 2021, across 4 billing codes. Its largest line is D0120, dental checkup, returning patient — 58% of everything it billed.
33Billing provider infoLAREDO COVENANT DENTAL, P.A.
LAREDO, TX 78045
LAREDO, TX 78045
33aNPI1477669257assigned 08/22/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$6K
24GClaims247
24DCodes billed4
24AFirst – last monthDec 2020 – Aug 2021
Compared with peers
Next to other General Practice Dentistry providers in Texas
Rank by total paid#2,055 of 2,774
Median peer was paid$43K
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 | |
|---|---|---|---|
| 2020 | 36 | $696.25 | |
| 2021 | 211 | $5K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 58% | 121 | 118 | $3K |
| D1208 | Topical application of fluoride, excluding varnish | 22% | 86 | 84 | $1K |
| D1110 | Prophylaxis - adult | 21% | 25 | 24 | $1K |
| D0602 | 0% | 15 | 15 | $0.00 |
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 officialLEE, JIN (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Jin Kyu Lee DDS INC | Huntington Park, CA | $178K |
| DJS Pharmacy LLC | Cary, NC | $0.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.