Kim, Tae

Kim, Tae was paid $187K by Medicaid between Oct 2020 and Nov 2024, across 12 billing codes. Its largest line is D2393, Resin-based composite - three surfaces, posterior, primary or permanent — 22% of everything it billed.

33Billing provider infoKIM, TAE
NORTH WALES, PA 19454

33aNPI1689748642assigned 11/20/2006

33bProvider typeGeneral Practice Dentistry

28Total paid$187K

24GClaims5,346

24DCodes billed12

24AFirst – last monthOct 2020 – Nov 2024

Compared with peers

Next to other General Practice Dentistry providers in Pennsylvania

Rank by total paid#172 of 847

Median peer was paid$37K

This provider vs. median5.1×

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
2020	529	$23K
2021	2,404	$82K
2024incomplete	2,413	$82K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	22%	696	332	$41K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	20%	672	332	$38K
D1110	Prophylaxis - adult	18%	1,016	999	$34K
D0274	Bitewings - four radiographic images	14%	976	960	$26K
D7140	Extraction, erupted tooth or exposed root	9.1%	326	130	$17K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	8.5%	827	818	$16K
D0150	Comprehensive oral evaluation - new or established patient	2.7%	261	249	$5K
D2391	Resin-based composite - one surface, posterior, primary or permanent	2.1%	76	29	$4K
D2332		1.7%	64	33	$3K
D0220	Intraoral - periapical first radiographic image	1.3%	341	338	$3K
D0230	Intraoral - periapical each additional radiographic image	<1%	65	65	$476.72
D1206	Topical application of fluoride varnish	<1%	26	26	$435.87

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.