Dental
Kona Pediatric Dentistry LLC
Kona Pediatric Dentistry LLC was paid $241K by Medicaid between Jan 2023 and Dec 2024, across 14 billing codes. Its largest line is D1120, dental cleaning, child — 21% of everything it billed.
33Billing provider infoKONA PEDIATRIC DENTISTRY LLC
KAILUA KONA, HI 96740
KAILUA KONA, HI 96740
33aNPI1235847807assigned 11/11/2022
33bProvider typePediatric Dentist
28Total paid$241K
24GClaims7,943
24DCodes billed14
24AFirst – last monthJan 2023 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Hawaii
Rank by total paid#23 of 35
Median peer was paid$411K
This provider vs. median0.6×
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 | |
|---|---|---|---|
| 2023 | 2,629 | $74K | |
| 2024incomplete | 5,314 | $167K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 21% | 1,317 | 1,317 | $50K |
| D1206 | Topical application of fluoride varnish | 13% | 1,169 | 1,169 | $32K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 736 | 736 | $26K |
| D0150 | Comprehensive oral evaluation - new or established patient | 11% | 584 | 584 | $26K |
| D0230 | Intraoral - periapical each additional radiographic image | 8.9% | 1,417 | 1,165 | $21K |
| D0220 | Intraoral - periapical first radiographic image | 8.8% | 1,226 | 1,212 | $21K |
| D0272 | Bitewings - two radiographic images | 8.5% | 808 | 808 | $21K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.4% | 146 | 88 | $18K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 4.5% | 197 | 191 | $11K |
| D0274 | Bitewings - four radiographic images | 2.5% | 111 | 111 | $6K |
| D7140 | Extraction, erupted tooth or exposed root | 2.3% | 73 | 30 | $6K |
| D0140 | Limited oral evaluation - problem focused | 1.6% | 109 | 108 | $4K |
2 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 officialGRIFFITH, THOMAS (PEDIATRIC DENTIST/OWNER)
| Provider | Location | Paid |
|---|---|---|
| City of Lancaster | Lancaster, TX | $962K |
| Pine Trees Pediatric Dentistry LLC | Kealakekua, HI | $2K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.