Clinic
Diana Kim Dental INC
Diana Kim Dental INC was paid $107K by Medicaid between Jul 2019 and Dec 2023, across 12 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 24% of everything it billed.
33Billing provider infoDIANA KIM DENTAL INC
COLTON, CA 92324
COLTON, CA 92324
33aNPI1902364185assigned 03/07/2019
33bProvider typeDental Clinic/Center
28Total paid$107K
24GClaims5,249
24DCodes billed12
24AFirst – last monthJul 2019 – Dec 2023
Compared with peers
Next to other Dental Clinic/Center providers in California
Rank by total paid#672 of 1,135
Median peer was paid$200K
This provider vs. median0.5×
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 | |
|---|---|---|---|
| 2019 | 1,160 | $22K | |
| 2020 | 1,266 | $29K | |
| 2021 | 1,222 | $24K | |
| 2022 | 1,278 | $27K | |
| 2023 | 323 | $5K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 24% | 401 | 399 | $26K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 22% | 442 | 194 | $24K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 15% | 253 | 122 | $17K |
| D0350 | 11% | 1,160 | 379 | $11K | |
| D0230 | Intraoral - periapical each additional radiographic image | 7.9% | 2,003 | 447 | $8K |
| D9430 | 4.2% | 142 | 136 | $5K | |
| D1206 | Topical application of fluoride varnish | 3.7% | 310 | 308 | $4K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 3.2% | 53 | 53 | $3K |
| D0210 | Intraoral - complete series of radiographic images | 3.0% | 67 | 67 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 2.9% | 263 | 244 | $3K |
| D1120 | Dental cleaning, childProphylaxis - child | 1.5% | 58 | 58 | $2K |
| D0272 | Bitewings - two radiographic images | 1.1% | 97 | 96 | $1K |
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 officialCASTELLON, MAYRA (SECRETARY)