Dental
Didomenico, Samantha
Didomenico, Samantha was paid $162K by Medicaid between Jul 2018 and Dec 2018, across 13 billing codes. Its largest line is D0999, Unspecified diagnostic procedure, by report — 76% of everything it billed.
33Billing provider infoDIDOMENICO, SAMANTHA
LAS ANIMAS, CO 81054
LAS ANIMAS, CO 81054
33aNPI1891241527assigned 09/01/2016
33bProvider typeGeneral Practice Dentistry
28Total paid$162K
24GClaims1,278
24DCodes billed13
24AFirst – last monthJul 2018 – Dec 2018
Compared with peers
Next to other General Practice Dentistry providers in Colorado
Rank by total paid#191 of 521
Median peer was paid$53K
This provider vs. median3.1×
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 | 1,278 | $162K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0999 | Unspecified diagnostic procedure, by report | 76% | 575 | 442 | $124K |
| D0330 | Panoramic radiographic image | 5.2% | 98 | 98 | $9K |
| D0140 | Limited oral evaluation - problem focused | 2.9% | 73 | 72 | $5K |
| D0274 | Bitewings - four radiographic images | 2.7% | 82 | 82 | $4K |
| D1110 | Prophylaxis - adult | 2.5% | 47 | 47 | $4K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.0% | 46 | 46 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 1.8% | 131 | 128 | $3K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 1.7% | 17 | 13 | $3K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 1.1% | 41 | 41 | $2K |
| D1206 | Topical application of fluoride varnish | 1.0% | 48 | 48 | $2K |
| D1120 | Dental cleaning, childProphylaxis - child | <1% | 26 | 26 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 12 | 12 | $2K |
1 more codes
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 82 | $1K |
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.