Dental
West Kauai Dental LLC
West Kauai Dental LLC was paid $73K by Medicaid between Sep 2019 and Nov 2024, across 9 billing codes. Its largest line is D0120, dental checkup, returning patient — 34% of everything it billed.
33Billing provider infoWEST KAUAI DENTAL LLC
HANAPEPE, HI 96716
HANAPEPE, HI 96716
33aNPI1053966689assigned 08/09/2019
33bProvider typeGeneral Practice Dentistry
28Total paid$73K
24GClaims2,157
24DCodes billed9
24AFirst – last monthSep 2019 – Nov 2024
Compared with peers
Next to other General Practice Dentistry providers in Hawaii
Rank by total paid#24 of 63
Median peer was paid$33K
This provider vs. median2.2×
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 | 25 | $702.24 | |
| 2020 | 214 | $6K | |
| 2021 | 318 | $9K | |
| 2022 | 220 | $6K | |
| 2023 | 526 | $21K | |
| 2024incomplete | 854 | $31K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 34% | 668 | 668 | $25K |
| D1110 | Prophylaxis - adult | 24% | 340 | 340 | $17K |
| D1206 | Topical application of fluoride varnish | 19% | 550 | 550 | $14K |
| D0274 | Bitewings - four radiographic images | 8.8% | 150 | 150 | $6K |
| D1120 | Dental cleaning, childProphylaxis - child | 5.3% | 120 | 120 | $4K |
| D1208 | Topical application of fluoride, excluding varnish | 4.5% | 234 | 234 | $3K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 4.3% | 30 | 15 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 1.1% | 49 | 49 | $796.25 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 16 | 16 | $191.20 |
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 officialCHUN, JASE (OWNER)