Dental
Samuel H. Ko, DDS, INC.
Samuel H. Ko, DDS, INC. was paid $6.95M by Medicaid between Jan 2018 and Dec 2024, across 28 billing codes. Its largest line is D0120, dental checkup, returning patient — 22% of everything it billed.
33Billing provider infoSAMUEL H. KO, DDS, INC.
VICTORVILLE, CA 92395
VICTORVILLE, CA 92395
33aNPI1770965535assigned 06/29/2015
33bProvider typeGeneral Practice Dentistry
28Total paid$6.95M
24GClaims275,978
24DCodes billed28
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in California
Rank by total paid#70 of 2,668
Median peer was paid$173K
This provider vs. median40×
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 | |
|---|---|---|---|
| 2018 | 53,188 | $1.17M | |
| 2019 | 47,764 | $1.09M | |
| 2020 | 33,684 | $746K | |
| 2021 | 36,881 | $847K | |
| 2022 | 36,095 | $1.09M | |
| 2023 | 34,264 | $1.01M | |
| 2024incomplete | 34,102 | $989K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 22% | 27,949 | 27,815 | $1.52M |
| D1120 | Dental cleaning, childProphylaxis - child | 17% | 31,138 | 30,957 | $1.19M |
| D1351 | Sealant - per tooth | 11% | 26,113 | 6,479 | $738K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 10.0% | 10,391 | 6,067 | $695K |
| D0272 | Bitewings - two radiographic images | 5.5% | 32,442 | 32,269 | $382K |
| D0150 | Comprehensive oral evaluation - new or established patient | 5.3% | 6,020 | 6,003 | $372K |
| D1208 | Topical application of fluoride, excluding varnish | 5.3% | 30,670 | 30,493 | $368K |
| D0230 | Intraoral - periapical each additional radiographic image | 4.6% | 81,020 | 39,467 | $321K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 3.1% | 1,866 | 1,459 | $218K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 3.1% | 2,167 | 1,632 | $214K |
| D2140 | 2.9% | 3,749 | 2,736 | $203K | |
| D2160 | 2.5% | 2,138 | 1,652 | $170K |
16 more codes
| D0220 | Intraoral - periapical first radiographic image | 2.0% | 11,924 | $140K |
| D1110 | Prophylaxis - adult | 1.9% | 1,527 | $130K |
| D0145 | Oral evaluation for a patient under three years of age | 1.3% | 1,557 | $90K |
| D9430 | 1.3% | 2,756 | $87K | |
| D2330 | <1% | 514 | $39K | |
| D1310 | <1% | 629 | $28K | |
| D2335 | <1% | 91 | $11K | |
| D1206 | Topical application of fluoride varnish | <1% | 409 | $7K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 117 | $7K |
| D0601 | <1% | 444 | $6K | |
| D2332 | <1% | 41 | $4K | |
| D0340 | <1% | 57 | $3K | |
| D4341 | <1% | 39 | $3K | |
| D2331 | <1% | 36 | $3K | |
| D0603 | <1% | 107 | $2K | |
| D0270 | <1% | 67 | $335.00 |
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 officialKO, SAMUEL (PRESIDENT/DENTIST)