Dental
Kim, Alisa
Kim, Alisa was paid $3K by Medicaid between Mar 2018 and May 2022, across 3 billing codes. Its largest line is D1110, Prophylaxis - adult — 58% of everything it billed.
33Billing provider infoKIM, ALISA
BROCKPORT, NY 14420
BROCKPORT, NY 14420
33aNPI1053540526assigned 07/06/2009
33bProvider typeDentist
28Total paid$3K
24GClaims90
24DCodes billed3
24AFirst – last monthMar 2018 – May 2022
Compared with peers
Next to other Dentist providers in New York
Rank by total paid#1,366 of 1,649
Median peer was paid$49K
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 | 65 | $3K | |
| 2022 | 25 | $529.15 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 58% | 35 | 35 | $2K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 36% | 43 | 41 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 5.5% | 12 | 12 | $171.00 |
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.