Dental
Ko, Heesoo
Ko, Heesoo was paid $265K by Medicaid between Dec 2019 and May 2020, across 19 billing codes. Its largest line is D4341, — 19% of everything it billed.
33Billing provider infoKO, HEESOO
DEDEDO, GU 96929
DEDEDO, GU 96929
33aNPI1639200934assigned 03/08/2007
33bProvider typePediatric Dentist
28Total paid$265K
24GClaims2,913
24DCodes billed19
24AFirst – last monthDec 2019 – May 2020
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 | |
|---|---|---|---|
| 2019 | 362 | $44K | |
| 2020 | 2,551 | $221K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D4341 | 19% | 350 | 88 | $51K | |
| D2930 | Prefabricated stainless steel crown - primary tooth | 19% | 321 | 67 | $49K |
| D9221 | 13% | 68 | 68 | $34K | |
| D1120 | Dental cleaning, childProphylaxis - child | 8.2% | 365 | 365 | $22K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 6.8% | 207 | 101 | $18K |
| D7140 | Extraction, erupted tooth or exposed root | 6.5% | 116 | 53 | $17K |
| D0150 | Comprehensive oral evaluation - new or established patient | 6.5% | 229 | 229 | $17K |
| D9220 | 5.3% | 68 | 68 | $14K | |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 2.4% | 149 | 149 | $6K |
| D0210 | Intraoral - complete series of radiographic images | 2.1% | 75 | 75 | $6K |
| D1203 | 1.8% | 227 | 227 | $5K | |
| D1351 | Sealant - per tooth | 1.6% | 140 | 15 | $4K |
7 more codes
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.5% | 119 | $4K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.4% | 139 | $4K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 1.3% | 37 | $4K |
| D2140 | 1.2% | 46 | $3K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 38 | $3K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 170 | $3K |
| D0274 | Bitewings - four radiographic images | <1% | 49 | $2K |
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.