Dental
Summit Family Dental of Kirtland, LLC
Summit Family Dental of Kirtland, LLC was paid $2.05M by Medicaid between Jan 2018 and Dec 2024, across 20 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 16% of everything it billed.
33Billing provider infoSUMMIT FAMILY DENTAL OF KIRTLAND, LLC
KIRTLAND, NM 87417
KIRTLAND, NM 87417
33aNPI1710215439assigned 11/19/2009
33bProvider typeGeneral Practice Dentistry
28Total paid$2.05M
24GClaims75,760
24DCodes billed20
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in New Mexico
Rank by total paid#22 of 202
Median peer was paid$44K
This provider vs. median47×
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 | 11,566 | $308K | |
| 2019 | 11,754 | $322K | |
| 2020 | 10,090 | $276K | |
| 2021 | 10,742 | $286K | |
| 2022 | 12,414 | $349K | |
| 2023 | 10,442 | $269K | |
| 2024incomplete | 8,752 | $244K |
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 | 16% | 4,656 | 2,594 | $328K |
| D0274 | Bitewings - four radiographic images | 15% | 10,921 | 10,805 | $314K |
| D0150 | Comprehensive oral evaluation - new or established patient | 14% | 8,307 | 8,226 | $284K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 7,485 | 7,421 | $234K |
| D1110 | Prophylaxis - adult | 7.1% | 3,339 | 3,308 | $147K |
| D1208 | Topical application of fluoride, excluding varnish | 7.1% | 8,156 | 8,068 | $145K |
| D0220 | Intraoral - periapical first radiographic image | 6.8% | 12,638 | 12,347 | $139K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.9% | 1,887 | 1,140 | $100K |
| D0230 | Intraoral - periapical each additional radiographic image | 4.5% | 10,464 | 10,207 | $93K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 3.6% | 3,504 | 3,465 | $74K |
| D0330 | Panoramic radiographic image | 2.7% | 1,182 | 1,173 | $56K |
| D0140 | Limited oral evaluation - problem focused | 2.6% | 1,844 | 1,804 | $54K |
8 more codes
| D7140 | Extraction, erupted tooth or exposed root | 1.1% | 347 | $22K |
| D4346 | <1% | 162 | $20K | |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | <1% | 157 | $18K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 123 | $11K |
| D2331 | <1% | 101 | $9K | |
| D1206 | Topical application of fluoride varnish | <1% | 297 | $6K |
| D1351 | Sealant - per tooth | <1% | 120 | $3K |
| D1999 | 0% | 70 | $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 officialCOLEMAN, CODY (OWNER)