Dental
Ketcherside Dental Corporation
Ketcherside Dental Corporation was paid $41K by Medicaid between Jul 2022 and Nov 2024, across 7 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 49% of everything it billed.
33Billing provider infoKETCHERSIDE DENTAL CORPORATION
CORONA, CA 92879
CORONA, CA 92879
33aNPI1629557517assigned 08/10/2018
33bProvider typeOrthodontics and Dentofacial Orthopedic Dentist
28Total paid$41K
24GClaims909
24DCodes billed7
24AFirst – last monthJul 2022 – Nov 2024
Compared with peers
Next to other Orthodontics and Dentofacial Orthopedic Dentist providers in California
Rank by total paid#189 of 251
Median peer was paid$303K
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 | |
|---|---|---|---|
| 2022 | 36 | $2K | |
| 2023 | 170 | $10K | |
| 2024incomplete | 703 | $30K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 49% | 312 | 312 | $20K |
| D0210 | Intraoral - complete series of radiographic images | 28% | 243 | 242 | $12K |
| D1120 | Dental cleaning, childProphylaxis - child | 14% | 110 | 110 | $6K |
| D1208 | Topical application of fluoride, excluding varnish | 4.5% | 126 | 126 | $2K |
| D1110 | Prophylaxis - adult | 2.6% | 12 | 12 | $1K |
| D9430 | 1.0% | 13 | 13 | $416.00 | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 93 | 56 | $376.65 |
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 officialKETCHERSIDE, HOMER (PRESIDENT)