Clinic
Ilcheon Joo DDS PC
Ilcheon Joo DDS PC was paid $100K by Medicaid between Jan 2021 and Dec 2024, across 13 billing codes. Its largest line is D1110, Prophylaxis - adult — 22% of everything it billed.
33Billing provider infoILCHEON JOO DDS PC
PINE GROVE, PA 17963
PINE GROVE, PA 17963
33aNPI1699006452assigned 01/19/2010
33bProvider typeDental Clinic/Center
28Total paid$100K
24GClaims3,063
24DCodes billed13
24AFirst – last monthJan 2021 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Pennsylvania
Rank by total paid#36 of 78
Median peer was paid$70K
This provider vs. median1.4×
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 | |
|---|---|---|---|
| 2021 | 203 | $6K | |
| 2024incomplete | 2,860 | $94K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 22% | 618 | 615 | $22K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 21% | 330 | 200 | $21K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 17% | 323 | 192 | $17K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 568 | 566 | $11K |
| D0274 | Bitewings - four radiographic images | 5.6% | 199 | 199 | $6K |
| D0150 | Comprehensive oral evaluation - new or established patient | 5.1% | 254 | 253 | $5K |
| D1120 | Dental cleaning, childProphylaxis - child | 4.1% | 136 | 136 | $4K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 3.2% | 51 | 40 | $3K |
| D1206 | Topical application of fluoride varnish | 3.2% | 177 | 177 | $3K |
| D0140 | Limited oral evaluation - problem focused | 2.9% | 72 | 70 | $3K |
| D1330 | 2.0% | 216 | 215 | $2K | |
| D0210 | Intraoral - complete series of radiographic images | 1.4% | 31 | 31 | $1K |
1 more codes
| D0220 | Intraoral - periapical first radiographic image | <1% | 88 | $713.00 |
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 officialJOO, ILCHEON (PRESIDENT/OWNER)