Clinic
Ancheta Pediatric Dental LLC
Ancheta Pediatric Dental LLC was paid $1.75M by Medicaid between Jan 2018 and Dec 2024, across 28 billing codes. Its largest line is D0120, dental checkup, returning patient — 12% of everything it billed.
33Billing provider infoANCHETA PEDIATRIC DENTAL LLC
AIEA, HI 96701
AIEA, HI 96701
33aNPI1891235560assigned 03/01/2017
33bProvider typeDental Clinic/Center
28Total paid$1.75M
24GClaims60,269
24DCodes billed28
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Hawaii
Rank by total paid#1 of 23
Median peer was paid$52K
This provider vs. median34×
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 | 11,330 | $346K | |
| 2019 | 9,641 | $278K | |
| 2020 | 6,267 | $149K | |
| 2021 | 9,031 | $262K | |
| 2022 | 9,388 | $257K | |
| 2023 | 8,192 | $251K | |
| 2024incomplete | 6,420 | $207K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 12% | 7,872 | 7,872 | $216K |
| D1120 | Dental cleaning, childProphylaxis - child | 12% | 7,160 | 7,160 | $204K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 7.8% | 2,659 | 1,201 | $136K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 6.8% | 1,518 | 618 | $119K |
| D1208 | Topical application of fluoride, excluding varnish | 6.3% | 8,108 | 8,108 | $110K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 5.5% | 963 | 428 | $96K |
| D0330 | Panoramic radiographic image | 5.4% | 1,786 | 1,784 | $95K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 4.5% | 1,194 | 498 | $79K |
| D0272 | Bitewings - two radiographic images | 4.2% | 3,924 | 3,924 | $74K |
| D0220 | Intraoral - periapical first radiographic image | 4.2% | 6,359 | 6,260 | $74K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.6% | 7,181 | 5,600 | $63K |
| D7140 | Extraction, erupted tooth or exposed root | 3.6% | 1,321 | 725 | $62K |
16 more codes
| D1351 | Sealant - per tooth | 3.4% | 2,143 | $60K |
| D2332 | 3.2% | 478 | $57K | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.2% | 984 | $56K |
| D1110 | Prophylaxis - adult | 2.9% | 1,327 | $51K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.4% | 547 | $43K |
| D0274 | Bitewings - four radiographic images | 2.3% | 1,390 | $40K |
| D2140 | 1.7% | 660 | $29K | |
| D0140 | Limited oral evaluation - problem focused | 1.6% | 1,000 | $28K |
| D2160 | 1.4% | 363 | $24K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1.0% | 117 | $18K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 256 | $7K |
| D9310 | <1% | 50 | $3K | |
| D2335 | <1% | 31 | $3K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 57 | $2K |
| D1206 | Topical application of fluoride varnish | <1% | 197 | $542.40 |
| D9985 | 0% | 624 | $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 officialANCHETA-CARROLL, JANEL (OWNER/PEDIATRIC DENTIST)