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    OpenPayerNPI Medicare & MedicaidHeesoo Ko
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    Heesoo Ko — Billing Profile & Reimbursement Data

    NPI 1639200934 · Dededo, GU · Pediatric Dentistry

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    Heesoo Ko is a pediatric dentistry provider located in Dededo, Guam. This profile covers 0 Medicare and 19 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationHeesoo Ko
    Address655 Harmon Loop Rd Ste 108
    CityDededo
    StateGU
    ZIP96929
    TaxonomyPediatric Dentistry
    NPI EnumeratedMarch 8, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$264.9K
    Medicare$0

    Key Findings

    HEESOO KO is effectively a Medicaid-focused pediatric dentistry provider with no Medicare billing on file and $264.9K in lifetime Medicaid revenue, indicating a single-payer footprint concentrated in state Medicaid rather than Medicare. The provider has been NPI-enumerated since 2007-03-08 (~19 years), signalling long-term local presence that aligns with steady Medicaid billing over time. Revenue concentration is meaningful: the top three Medicaid codes by revenue account for 50.7% of total Medicaid revenue, showing that a small set of services generates half of the providers Medicaid income. The single largest revenue driver is D4341 (periodontal scaling and root planing - four or more teeth per quadrant) with $50.8K (19.2% of Medicaid revenue) and 350 claims; this code ranks #1 of 4 providers in-state (100th percentile), indicating the provider is a leading in-state source for multi-quadrant periodontal therapy within the pediatric dentistry taxonomy. D2930 is the second-largest code line with $49.4K (18.7% of revenue) across 321 claims and ranks #6 of 7 providers in-state (17th percentile), which suggests typical in-state competition for that procedure rather than dominance. High-dollar, lower-volume procedures such as D9221 ($34.1K, 68 claims; 12.9% of revenue) and D9220 ($13.9K, 68 claims; 5.3% of revenue) appear in the top revenue mix; both are sole-reporting in-state (rank #1 of 1) meaning there are no direct state peers for these specific codes, positioning the provider as the only Medicaid biller for those services in the available state dataset. Routine pediatric preventive and diagnostic codes (for example D1120 prophylaxis–child at $21.9K and D0150 comprehensive evaluation at $17.2K) together represent a material portion of billing, implying the practice manages a mix of preventive care alongside higher-revenue periodontal and operative services. Across its top codes most rank in low-to-mid percentiles among in-state peers (many described as "typical, unremarkable volume"), so while HEESOO KO is a notable local provider for specific services like D4341 and unique reporters for D9221/D9220, its overall competitive standing is more modest across the broader set of common pediatric dental procedures.

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    19 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    D4341Periodontal scaling and root planing - four or more teeth per quadrant350$150$50.8K
    D2930N/A320$150$49.4K
    D9221N/A70$500$34.1K
    D1120Prophylaxis–child370$60$21.9K
    D2150Amalgam - two surfaces, primary or permanent210$90$18K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)120$150$17.3K
    D0150Comprehensive oral evaluation – new or established patient230$80$17.2K
    D9220N/A70$210$13.9K
    D0120Periodic oral evaluation - established patient150$40$6.4K
    D0210Intraoral - complete series of radiographic images80$80$5.6K

    Showing 1–10 of 19

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Guam providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Guam median

    19 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    D2930N/A610570$180$587.4K
    D3220N/A610560$110$406.3K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)710490$160$322.3K
    D2150Amalgam - two surfaces, primary or permanent8101,360$100$315.6K
    D1120Prophylaxis–child9102,140$60$195.3K
    D0150Comprehensive oral evaluation – new or established patient7101,460$70$192.7K
    D2140Amalgam - one surface, primary or permanent710510$80$134.2K
    D1351Sealant - per tooth810280$30$115.1K
    D0230Intraoral - periapical each additional radiographic image10101,370$20$85.3K
    D0120Periodic oral evaluation - established patient9101,070$40$80K

    Showing 1–10 of 19

    Nearby Providers

    Other providers in the same ZIP code as Heesoo Ko, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Guam Healthcare Development IncorporatedGUClinic/Center$0$30.8M
    C V Alegria Dds IncGUGeneral Practice Dentistry$0$11.3M
    Albert HuangGUDentist$0$5.4M
    Usrc Finegayan, LLCGUEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$4.5M
    Renal Centers Of Guam, LLCGUEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$4.1M
    Government Of Guam Department Of AdministrationGUFederally Qualified Health Center (FQHC)$0$2.4M
    Maria Chela MarianoGUFamily Medicine Physician$0$1.8M
    Scott ShayGUVascular & Interventional Radiology Physician$1.2M$0
    Anthony BekkermanGUEmergency Medicine Physician$49.5K$623.9K
    Blue Ocean Medical Group LLCGUFamily Medicine Physician$0$665.1K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

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    Medicaid Revenue by Year vs. Guam Providers
    0 of 2 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Guam Distribution
    Heesoo Ko — 1 of 19 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Guam