Pan, Simon

Pan, Simon was paid $2K by Medicaid between Jul 2023 and Sep 2023, across 4 billing codes. Its largest line is D1110, Prophylaxis - adult — 56% of everything it billed.

33Billing provider infoPAN, SIMON
S EL MONTE, CA 91733

33aNPI1558316158assigned 05/23/2006

33bProvider typeDentist

28Total paid$2K

24GClaims82

24DCodes billed4

24AFirst – last monthJul 2023 – Sep 2023

Compared with peers

Next to other Dentist providers in California

Rank by total paid#2,086 of 2,314

Median peer was paid$185K

This provider vs. median0.0×

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
2023	82	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	56%	15	15	$1K
D1208	Topical application of fluoride, excluding varnish	30%	28	28	$709.30
D1320		8.1%	26	26	$195.00
D0220	Intraoral - periapical first radiographic image	6.6%	13	12	$158.00

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.