Embudo Dental Center LLC

Embudo Dental Center LLC was paid $21K by Medicaid between Mar 2018 and Aug 2019, across 8 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 38% of everything it billed.

33Billing provider infoEMBUDO DENTAL CENTER LLC
EMBUDO, NM 87531

33aNPI1679017453assigned 12/13/2016

33bProvider typeDental Clinic/Center

28Total paid$21K

24GClaims514

24DCodes billed8

24AFirst – last monthMar 2018 – Aug 2019

Compared with peers

Next to other Dental Clinic/Center providers in New Mexico

Rank by total paid#36 of 41

Median peer was paid$351K

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	111	$4K
2019	403	$17K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0150	Comprehensive oral evaluation - new or established patient	38%	230	230	$8K
D1110	Prophylaxis - adult	24%	110	110	$5K
D0210	Intraoral - complete series of radiographic images	18%	61	61	$4K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	6.9%	20	15	$1K
D0140	Limited oral evaluation - problem focused	6.8%	51	50	$1K
D7140	Extraction, erupted tooth or exposed root	4.2%	13	12	$875.49
D0274	Bitewings - four radiographic images	2.1%	15	15	$440.41
D0220	Intraoral - periapical first radiographic image	<1%	14	14	$158.91

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 officialHARRIS, KELLIE (OWNER/DENTIST)