Dental
Lee, Kunsun
Lee, Kunsun was paid $168K by Medicaid between Dec 2019 and Oct 2024, across 12 billing codes. Its largest line is D1120, dental cleaning, child — 42% of everything it billed.
33Billing provider infoLEE, KUNSUN
HAGATNA, GU 96910
HAGATNA, GU 96910
33aNPI1316324999assigned 05/02/2015
33bProvider typeDentist
28Total paid$168K
24GClaims3,923
24DCodes billed12
24AFirst – last monthDec 2019 – Oct 2024
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 | |
|---|---|---|---|
| 2019 | 13 | $720.00 | |
| 2020 | 269 | $19K | |
| 2021 | 430 | $18K | |
| 2022 | 995 | $40K | |
| 2023 | 1,082 | $46K | |
| 2024incomplete | 1,134 | $45K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 42% | 1,261 | 1,250 | $71K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 26% | 1,065 | 1,057 | $43K |
| D1203 | 6.7% | 580 | 576 | $11K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 4.9% | 115 | 113 | $8K |
| D0230 | Intraoral - periapical each additional radiographic image | 4.5% | 284 | 279 | $8K |
| D1351 | Sealant - per tooth | 4.5% | 170 | 52 | $8K |
| D4220 | 4.4% | 13 | 12 | $7K | |
| D0220 | Intraoral - periapical first radiographic image | 2.9% | 350 | 343 | $5K |
| D2940 | 2.1% | 15 | 15 | $4K | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 40 | 33 | $1K |
| D0140 | Limited oral evaluation - problem focused | <1% | 14 | 14 | $938.00 |
| D1110 | Prophylaxis - adult | <1% | 16 | 16 | $832.00 |
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.