Waikoloa Dental Clinic INC

Waikoloa Dental Clinic INC was paid $4K by Medicaid between May 2018 and Jul 2019, across 3 billing codes. Its largest line is D0120, dental checkup, returning patient — 48% of everything it billed.

33Billing provider infoWAIKOLOA DENTAL CLINIC INC
WAIKOLOA, HI 96738

33aNPI1003228982assigned 05/27/2014

33bProvider typeGeneral Practice Dentistry

28Total paid$4K

24GClaims128

24DCodes billed3

24AFirst – last monthMay 2018 – Jul 2019

Compared with peers

Next to other General Practice Dentistry providers in Hawaii

Rank by total paid#55 of 63

Median peer was paid$33K

This provider vs. median0.1×

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	62	$2K
2019	66	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	48%	49	49	$2K
D1120	Dental cleaning, childProphylaxis - child	44%	50	50	$2K
D1208	Topical application of fluoride, excluding varnish	7.5%	29	29	$285.73

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 officialFOSTVEDT, CRAIG (DENTIST/OWNER)