Wailuku Dentists LLC

Wailuku Dentists LLC was paid $424K by Medicaid between Jan 2018 and Sep 2022, across 16 billing codes. Its largest line is D0140, Limited oral evaluation - problem focused — 24% of everything it billed.

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	4,497	$138K
2019	3,342	$119K
2020	3,154	$97K
2021	1,472	$45K
2022	1,029	$25K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0140	Limited oral evaluation - problem focused	24%	2,824	2,592	$103K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth	17%	501	328	$74K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	15%	1,682	1,681	$63K
D1120	Dental cleaning, childProphylaxis - child	12%	1,461	1,461	$49K
D0220	Intraoral - periapical first radiographic image	8.1%	2,232	2,118	$34K
D1110	Prophylaxis - adult	4.4%	377	377	$19K
D0230	Intraoral - periapical each additional radiographic image	3.9%	1,504	1,057	$17K
D1208	Topical application of fluoride, excluding varnish	3.8%	1,531	1,530	$16K
D0274	Bitewings - four radiographic images	3.4%	342	342	$15K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	2.8%	188	124	$12K
D0150	Comprehensive oral evaluation - new or established patient	1.7%	193	193	$7K
D0330	Panoramic radiographic image	1.7%	97	97	$7K

4 more codes

D1206	Topical application of fluoride varnish	1.6%	492	$7K
D2391	Resin-based composite - one surface, posterior, primary or permanent	<1%	40	$2K
D0272	Bitewings - two radiographic images	<1%	12	$312.00
D1999		0%	18	$0.00

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 officialKIDO, NOLAN (DULY AUTHORIZED AGENT)