Clinic
Kidshine Kapolei LLC
Kidshine Kapolei LLC was paid $1.50M by Medicaid between Sep 2019 and Dec 2024, across 22 billing codes. Its largest line is D0120, dental checkup, returning patient — 23% of everything it billed.
33Billing provider infoKIDSHINE KAPOLEI LLC
KAPOLEI, HI 96707
KAPOLEI, HI 96707
33aNPI1558839589assigned 11/07/2018
33bProvider typeDental Clinic/Center
28Total paid$1.50M
24GClaims53,725
24DCodes billed22
24AFirst – last monthSep 2019 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Hawaii
Rank by total paid#2 of 23
Median peer was paid$52K
This provider vs. median29×
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 | 856 | $30K | |
| 2020 | 3,509 | $123K | |
| 2021 | 7,357 | $220K | |
| 2022 | 8,401 | $223K | |
| 2023 | 16,501 | $416K | |
| 2024incomplete | 17,101 | $485K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 23% | 12,189 | 12,188 | $338K |
| D1120 | Dental cleaning, childProphylaxis - child | 14% | 7,436 | 7,436 | $205K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 12% | 2,579 | 1,422 | $185K |
| D1206 | Topical application of fluoride varnish | 10% | 7,284 | 7,284 | $153K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 9.1% | 2,595 | 2,482 | $137K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 6.0% | 1,037 | 585 | $90K |
| D0220 | Intraoral - periapical first radiographic image | 4.8% | 6,424 | 6,402 | $72K |
| D0272 | Bitewings - two radiographic images | 4.6% | 3,841 | 3,841 | $69K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.9% | 4,761 | 4,603 | $43K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.8% | 587 | 397 | $41K |
| D1351 | Sealant - per tooth | 2.2% | 1,262 | 419 | $33K |
| D0330 | Panoramic radiographic image | 2.1% | 634 | 634 | $32K |
10 more codes
| D0274 | Bitewings - four radiographic images | 1.6% | 808 | $24K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.3% | 658 | $20K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 289 | $14K |
| D1110 | Prophylaxis - adult | <1% | 319 | $12K |
| D0240 | <1% | 495 | $10K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 273 | $9K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 93 | $6K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 65 | $2K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 15 | $847.56 |
| D1354 | <1% | 81 | $546.66 |
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 officialMARTIN, JESSI-CHARET (HOSPITAL COORDINATOR)