Clinic
KSL Dental Group INC
KSL Dental Group INC was paid $256K by Medicaid between Aug 2018 and Nov 2024, across 14 billing codes. Its largest line is D2751, Crown - porcelain fused to predominantly base metal — 47% of everything it billed.
33Billing provider infoKSL DENTAL GROUP INC
ONTARIO, CA 91762
ONTARIO, CA 91762
33aNPI1033592241assigned 07/07/2015
33bProvider typeDental Clinic/Center
28Total paid$256K
24GClaims3,162
24DCodes billed14
24AFirst – last monthAug 2018 – Nov 2024
Compared with peers
Next to other Dental Clinic/Center providers in California
Rank by total paid#519 of 1,135
Median peer was paid$200K
This provider vs. median1.3×
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 | 12 | $792.00 | |
| 2020 | 45 | $3K | |
| 2021 | 66 | $4K | |
| 2023 | 1,421 | $146K | |
| 2024incomplete | 1,618 | $102K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2751 | Crown - porcelain fused to predominantly base metal | 47% | 253 | 163 | $120K |
| D0150 | Comprehensive oral evaluation - new or established patient | 14% | 545 | 545 | $36K |
| D0210 | Intraoral - complete series of radiographic images | 7.3% | 394 | 394 | $19K |
| D4910 | 5.8% | 194 | 194 | $15K | |
| D4341 | 5.5% | 201 | 77 | $14K | |
| D2954 | 5.1% | 124 | 89 | $13K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.6% | 136 | 53 | $9K |
| D2740 | Crown - porcelain/ceramic | 3.3% | 18 | 12 | $9K |
| D1120 | Dental cleaning, childProphylaxis - child | 2.6% | 128 | 128 | $7K |
| D1208 | Topical application of fluoride, excluding varnish | 2.0% | 355 | 355 | $5K |
| D1110 | Prophylaxis - adult | 1.8% | 55 | 55 | $5K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.1% | 706 | 157 | $3K |
2 more codes
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 officialAMER, NEVEIN (PRESIDENT/OWNER)