Dental
Jae Kwon Bok DDS PC
Jae Kwon Bok DDS PC was paid $341K by Medicaid between Jan 2018 and Sep 2024, across 13 billing codes. Its largest line is D1110, Prophylaxis - adult — 19% of everything it billed.
33Billing provider infoJAE KWON BOK DDS PC
ANNANDALE, VA 22003
ANNANDALE, VA 22003
33aNPI1164692448assigned 03/03/2008
33bProvider typeDentist
28Total paid$341K
24GClaims13,771
24DCodes billed13
24AFirst – last monthJan 2018 – Sep 2024
Compared with peers
Next to other Dentist providers in Virginia
Rank by total paid#75 of 417
Median peer was paid$34K
This provider vs. median10×
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 | |
|---|---|---|---|
| 2018 | 1,541 | $47K | |
| 2019 | 2,053 | $64K | |
| 2020 | 1,378 | $36K | |
| 2021 | 2,152 | $61K | |
| 2022 | 2,378 | $85K | |
| 2023 | 2,618 | $48K | |
| 2024incomplete | 1,651 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 19% | 1,798 | 1,774 | $65K |
| D1208 | Topical application of fluoride, excluding varnish | 17% | 3,259 | 3,236 | $58K |
| D1120 | Dental cleaning, childProphylaxis - child | 17% | 1,979 | 1,968 | $58K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 17% | 3,414 | 3,383 | $57K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 10% | 552 | 308 | $36K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 7.4% | 327 | 158 | $25K |
| D0274 | Bitewings - four radiographic images | 5.7% | 914 | 899 | $19K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.2% | 418 | 415 | $11K |
| D0220 | Intraoral - periapical first radiographic image | 1.3% | 571 | 554 | $4K |
| D0272 | Bitewings - two radiographic images | <1% | 138 | 138 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 259 | 194 | $2K |
| D0140 | Limited oral evaluation - problem focused | <1% | 113 | 112 | $1K |
1 more codes
| D0210 | Intraoral - complete series of radiographic images | <1% | 29 | $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 officialBOK, JAE (PRESIDENT)