SEAN KIM, DDS, INC.
NPI: 1306323035
· PASADENA, CA 91104
· Dental Clinic/Center
· NPI assigned 07/25/2018
$120K
Total Medicaid Paid
Provider Details
| Authorized Official | SUNYOTO, SEAN (DENTIST) |
| NPI Enumeration Date | 07/25/2018 |
Related Entities
Other providers sharing the same authorized official: SUNYOTO, SEAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
193 |
$9K |
| 2021 |
432 |
$20K |
| 2022 |
634 |
$28K |
| 2023 |
766 |
$31K |
| 2024 |
771 |
$32K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
640 |
640 |
$42K |
| D1110 |
Prophylaxis - adult |
286 |
286 |
$26K |
| D0210 |
Intraoral - complete series of radiographic images |
361 |
361 |
$17K |
| D0120 |
Periodic oral evaluation - established patient |
144 |
144 |
$11K |
| D1208 |
Topical application of fluoride, excluding varnish |
490 |
490 |
$7K |
| D9430 |
|
134 |
133 |
$4K |
| D0330 |
Panoramic radiographic image |
246 |
246 |
$4K |
| D0350 |
|
88 |
84 |
$2K |
| D1320 |
|
105 |
104 |
$2K |
| D0274 |
Bitewings - four radiographic images |
79 |
79 |
$2K |
| D1206 |
Topical application of fluoride varnish |
69 |
69 |
$965.50 |
| D4910 |
|
12 |
12 |
$924.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
142 |
75 |
$874.80 |