Dental
Ansony Kim, DDS INC
Ansony Kim, DDS INC was paid $561K by Medicaid between Jun 2020 and Dec 2024, across 19 billing codes. Its largest line is D0120, dental checkup, returning patient — 29% of everything it billed.
33Billing provider infoANSONY KIM, DDS INC
OAKLEY, CA 94561
OAKLEY, CA 94561
33aNPI1629629134assigned 09/25/2019
33bProvider typePediatric Dentist
28Total paid$561K
24GClaims20,470
24DCodes billed19
24AFirst – last monthJun 2020 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in California
Rank by total paid#162 of 332
Median peer was paid$450K
This provider vs. median1.2×
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 | |
|---|---|---|---|
| 2020 | 1,448 | $35K | |
| 2021 | 6,473 | $144K | |
| 2022 | 5,431 | $161K | |
| 2023 | 4,181 | $127K | |
| 2024incomplete | 2,937 | $94K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 29% | 2,532 | 2,523 | $161K |
| D1120 | Dental cleaning, childProphylaxis - child | 25% | 3,389 | 3,377 | $140K |
| D1206 | Topical application of fluoride varnish | 9.4% | 3,243 | 3,232 | $53K |
| D1310 | 6.7% | 846 | 842 | $37K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 6.4% | 566 | 566 | $36K |
| D1351 | Sealant - per tooth | 4.2% | 1,020 | 265 | $24K |
| D0272 | Bitewings - two radiographic images | 3.8% | 1,899 | 1,896 | $21K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.3% | 307 | 168 | $19K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.3% | 4,886 | 2,471 | $19K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.1% | 440 | 409 | $17K |
| D0145 | Oral evaluation for a patient under three years of age | 2.2% | 194 | 192 | $13K |
| D0603 | 1.1% | 480 | 479 | $6K |
7 more codes
| D0330 | Panoramic radiographic image | <1% | 151 | $4K |
| D0274 | Bitewings - four radiographic images | <1% | 191 | $4K |
| D2930 | Prefabricated stainless steel crown - primary tooth | <1% | 23 | $3K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 132 | $2K |
| D0602 | <1% | 69 | $1K | |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 22 | $922.20 |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 80 | $787.00 |
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.
From NPPES
Who's on the registration
Authorized officialKIM, ANSONY (OWNER)