SUNG KOO KIM,DDS,INC.
NPI: 1437523883
· ROWLAND HEIGHTS, CA 91748
· Dental Clinic/Center
· NPI assigned 11/23/2015
$112K
Total Medicaid Paid
Provider Details
| Authorized Official | KIM, SUNG (CEO) |
| NPI Enumeration Date | 11/23/2015 |
Related Entities
Other providers sharing the same authorized official: KIM, SUNG
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
450 |
$12K |
| 2019 |
393 |
$13K |
| 2020 |
362 |
$12K |
| 2021 |
234 |
$7K |
| 2022 |
634 |
$21K |
| 2023 |
1,161 |
$29K |
| 2024 |
896 |
$19K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
444 |
441 |
$27K |
| D1110 |
Prophylaxis - adult |
235 |
235 |
$20K |
| D0120 |
Periodic oral evaluation - established patient |
267 |
266 |
$17K |
| D9430 |
|
563 |
406 |
$17K |
| D1208 |
Topical application of fluoride, excluding varnish |
834 |
832 |
$11K |
| D0330 |
Panoramic radiographic image |
372 |
367 |
$11K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,207 |
579 |
$6K |
| D0274 |
Bitewings - four radiographic images |
128 |
128 |
$2K |
| D1120 |
Prophylaxis - child |
26 |
26 |
$990.00 |
| D0220 |
Intraoral - periapical first radiographic image |
54 |
47 |
$561.00 |