Dental
100 South Bloomfield Professional, LLC
100 South Bloomfield Professional, LLC was paid $506K by Medicaid between Nov 2020 and Dec 2024, across 21 billing codes. Its largest line is D0274, Bitewings - four radiographic images — 11% of everything it billed.
33Billing provider info100 SOUTH BLOOMFIELD PROFESSIONAL, LLC
BLOOMFIELD, NM 87413
BLOOMFIELD, NM 87413
33aNPI1912519067assigned 08/20/2020
33bProvider typeGeneral Practice Dentistry
28Total paid$506K
24GClaims17,443
24DCodes billed21
24AFirst – last monthNov 2020 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in New Mexico
Rank by total paid#45 of 202
Median peer was paid$44K
This provider vs. median12×
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 | 24 | $0.00 | |
| 2021 | 4,032 | $112K | |
| 2022 | 4,298 | $122K | |
| 2023 | 3,058 | $70K | |
| 2024incomplete | 6,031 | $202K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0274 | Bitewings - four radiographic images | 11% | 1,949 | 1,925 | $55K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 1,780 | 1,757 | $55K |
| D0150 | Comprehensive oral evaluation - new or established patient | 9.2% | 1,345 | 1,335 | $47K |
| D1208 | Topical application of fluoride, excluding varnish | 8.8% | 2,522 | 2,488 | $45K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 8.5% | 585 | 382 | $43K |
| D0210 | Intraoral - complete series of radiographic images | 6.3% | 536 | 527 | $32K |
| D1110 | Prophylaxis - adult | 6.0% | 695 | 686 | $31K |
| D0220 | Intraoral - periapical first radiographic image | 6.0% | 2,780 | 2,712 | $30K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 6.0% | 270 | 103 | $30K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.5% | 509 | 279 | $28K |
| D7140 | Extraction, erupted tooth or exposed root | 5.4% | 413 | 265 | $27K |
| D0140 | Limited oral evaluation - problem focused | 4.2% | 737 | 723 | $21K |
9 more codes
| D0230 | Intraoral - periapical each additional radiographic image | 4.1% | 2,276 | $21K |
| D0120 | Dental checkup, returning patient | 2.6% | 591 | $13K |
| D4346 | 2.1% | 91 | $11K | |
| D0330 | Panoramic radiographic image | 1.7% | 175 | $8K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 57 | $5K |
| D2335 | <1% | 21 | $2K | |
| D1351 | Sealant - per tooth | <1% | 45 | $1K |
| D1206 | Topical application of fluoride varnish | <1% | 42 | $683.76 |
| D1999 | 0% | 24 | $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 officialGRUMBOS, PETER (OWNER)
| Provider | Location | Paid |
|---|---|---|
| 1661 W 2ND Corsicana Professional, PLLC | Corsicana, TX | $1.65M |
| 3501 North Butler Avenue Farmington Professional LLC | Farmington, NM | $1.05M |
| 920 Lobo Canyon Grants Professional, LLC | Grants, NM | $560K |
| Lubbock Dental Care Professionals, PLLC | Lubbock, TX | $253K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.