JAE EUN KIM, DMD DENTISTRY INC
NPI: 1043927015
· PICO RIVERA, CA 90660
· Dental Clinic/Center
· NPI assigned 10/31/2022
Provider Details
| Authorized Official | KIM, JAE EUN (OWNER DENTIST) |
| NPI Enumeration Date | 10/31/2022 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
17 |
$1K |
| 2023 |
208 |
$5K |
| 2024 |
1,111 |
$36K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
232 |
228 |
$15K |
| D2751 |
Crown - porcelain fused to predominantly base metal |
22 |
13 |
$10K |
| D0210 |
Intraoral - complete series of radiographic images |
133 |
133 |
$6K |
| D1320 |
|
213 |
213 |
$3K |
| D2954 |
|
23 |
13 |
$2K |
| D9430 |
|
70 |
62 |
$2K |
| D0330 |
Panoramic radiographic image |
152 |
152 |
$960.00 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$915.00 |
| D1120 |
Prophylaxis - child |
13 |
13 |
$577.50 |
| D1206 |
Topical application of fluoride varnish |
25 |
25 |
$431.50 |
| D0274 |
Bitewings - four radiographic images |
13 |
13 |
$216.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
24 |
13 |
$89.10 |
| D1310 |
|
203 |
203 |
$66.00 |
| D9993 |
|
26 |
26 |
$0.00 |
| D1330 |
|
174 |
174 |
$0.00 |