Clinic
Jin Kyu Lee DDS INC
Jin Kyu Lee DDS INC was paid $178K by Medicaid between Apr 2019 and Dec 2024, across 17 billing codes. Its largest line is D1110, Prophylaxis - adult — 30% of everything it billed.
33Billing provider infoJIN KYU LEE DDS INC
HUNTINGTON PARK, CA 90255
HUNTINGTON PARK, CA 90255
33aNPI1841761335assigned 12/10/2018
33bProvider typeDental Clinic/Center
28Total paid$178K
24GClaims5,883
24DCodes billed17
24AFirst – last monthApr 2019 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in California
Rank by total paid#585 of 1,135
Median peer was paid$200K
This provider vs. median0.9×
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 | |
|---|---|---|---|
| 2019 | 155 | $10K | |
| 2020 | 94 | $4K | |
| 2021 | 333 | $15K | |
| 2022 | 977 | $26K | |
| 2023 | 1,759 | $42K | |
| 2024incomplete | 2,565 | $81K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 30% | 611 | 611 | $54K |
| D0150 | Comprehensive oral evaluation - new or established patient | 23% | 615 | 615 | $41K |
| D9430 | 9.4% | 520 | 451 | $17K | |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.8% | 206 | 201 | $16K |
| D0230 | Intraoral - periapical each additional radiographic image | 5.6% | 2,465 | 522 | $10K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 5.3% | 82 | 51 | $9K |
| D1206 | Topical application of fluoride varnish | 4.8% | 481 | 481 | $8K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 2.5% | 65 | 27 | $4K |
| D0272 | Bitewings - two radiographic images | 2.0% | 296 | 296 | $4K |
| D4341 | 1.9% | 48 | 12 | $3K | |
| D0210 | Intraoral - complete series of radiographic images | 1.8% | 65 | 65 | $3K |
| D0330 | Panoramic radiographic image | 1.6% | 100 | 100 | $3K |
5 more codes
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 officialLEE, JIN (OWNER / CEO / PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Laredo Covenant Dental, P.A. | Laredo, TX | $6K |
| DJS Pharmacy LLC | Cary, NC | $0.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.