KOO DDS INC
NPI: 1396759668
· PANORAMA CITY, CA 91402
· Dentist
· NPI assigned 07/29/2006
$230K
Total Medicaid Paid
Provider Details
| Authorized Official | CHO, GRACE (PRESIDENT) |
| NPI Enumeration Date | 07/29/2006 |
Related Entities
Other providers sharing the same authorized official: CHO, GRACE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,944 |
$38K |
| 2019 |
1,344 |
$45K |
| 2020 |
744 |
$15K |
| 2021 |
1,008 |
$27K |
| 2022 |
830 |
$36K |
| 2023 |
728 |
$34K |
| 2024 |
721 |
$36K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,255 |
1,252 |
$65K |
| D1110 |
Prophylaxis - adult |
598 |
596 |
$46K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
540 |
537 |
$29K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,880 |
1,867 |
$24K |
| D1120 |
Prophylaxis - child |
643 |
641 |
$21K |
| D0210 |
Intraoral - complete series of radiographic images |
325 |
324 |
$14K |
| D4341 |
|
121 |
40 |
$7K |
| D1351 |
Sealant - per tooth |
348 |
97 |
$7K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
102 |
55 |
$7K |
| D0330 |
Panoramic radiographic image |
221 |
220 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
861 |
286 |
$3K |
| D0274 |
Bitewings - four radiographic images |
88 |
88 |
$1K |
| D1999 |
|
337 |
322 |
$140.00 |