Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Hawaii for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Hawaii only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Hawaii (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Hawaii Dental Group, Inc. (NPI 1205992922)

Field	Value
Entity Type	Organization
Organization	Hawaii Dental Group, Inc.
Address	500 Ala Moana Blvd
City	Honolulu
State	HI
ZIP	96813
Taxonomy	General Practice Dentistry
NPI Enumerated	December 28, 2006

Payer Source	Total Paid
Medicaid	$12.4M
Medicare	$0

Key Findings

HAWAII DENTAL GROUP, INC. is effectively a Medicaid-focused dental practice with no Medicare billing on file and $12.4M in lifetime Medicaid revenue, indicating its clinical and payer footprint is concentrated in state Medicaid programs rather than Medicare beneficiaries. The absence of Medicare revenue means all payer-mix analysis should treat this entity as a single-payer (Medicaid) operation for available claims data.

Revenue is highly concentrated in a small set of services: the precomputed top three Medicaid codes account for 37.9% of the provider’s total Medicaid revenue, signaling reliance on a narrow set of high-volume pediatric/preventive and evaluation codes to drive a large share of income. Given that D1120, D2930, and D0120 are among the top contributors, routine prophylaxis and periodic evaluations form a major portion of billed activity.

The code-level mix reflects a high-volume general practice with a strong pediatric/preventive orientation: D1120 (Prophylaxis–child), D0120 (Periodic oral evaluation - established patient), D1206/ D1208 (Topical fluoride treatments), and D1351 (Sealant - per tooth) are prominent, consistent with a practice that delivers large quantities of preventive dental care and routine evaluations for children and adolescents. Restorative codes such as D2392 and D2391 and extractions (D7140, D7210) also appear, indicating the practice handles both preventive and common restorative/extraction needs.

HAWAII DENTAL GROUP is a dominant statewide provider for many Medicaid codes: it ranks #1 in-state for D1120, D2930, D0120, D1351, D0274, D1206, D2392, D9230, D0220, D0150 and several others, frequently sitting at the 100th percentile and described as an extreme outlier. These rank and percentile levels indicate the group operates at far higher volume than typical peers in Hawaii for core pediatric and preventive services, positioning it as a major statewide provider for those codes.

Several codes show exceptionally large volume and outlier status that shape operational capacity and revenue risk: for example, D1120 generated $1.7M (13.7% of Medicaid revenue) with 45.6K claims and is labeled an extreme outlier, and D0120 generated $1.4M (11.1%) with 39K claims and likewise ranks as an extreme outlier. Those concentrations imply that changes in reimbursement or utilization patterns for pediatric prophylaxis and periodic evaluations would materially affect overall revenue.

While many codes are extreme outliers, some services are closer to typical statewide participation: codes such as D0230 (ranks #2, 99th percentile), D0140 (rank #7, 95th percentile), and D0210 (rank #3, 95th percentile) remain well above average but not absolute outliers, suggesting the practice has breadth across diagnostic imaging and problem-focused evaluations in addition to its dominant pediatric preventive services.

The provider has been enumerated since 2006-12-28 (~20 years ago), indicating long tenure in the market; combined with the high-volume, statewide-leading code ranks, this history supports a sustained operational presence and likely established referral or access patterns within Hawaii Medicaid.

Operationally, the high counts for low-unit-value pediatric/preventive codes (e.g., D1120: 45.6K claims at $37 avg; D0120: 39K claims at $35 avg) suggest throughput-driven revenue model relying on large patient volumes and frequent routine visits, whereas higher-paid procedures (e.g., D7230 at $297 avg, D7210 at $162 avg) contribute meaningful but smaller shares of total Medicaid revenue.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

34 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1120	Prophylaxis–child	45,590	$40	$1.7M
D2930	N/A	15,220	$110	$1.6M
D0120	Periodic oral evaluation - established patient	39,000	$40	$1.4M
D1351	Sealant - per tooth	21,010	$40	$882.3K
D0274	N/A	16,050	$50	$818.4K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	42,770	$20	$812.6K
D2392	Post 2 surface resin‑based composite	9,100	$80	$728K
D9230	N/A	10,680	$60	$598.1K
D0220	Intraoral - periapical first radiographic image	33,860	$20	$575.6K
D0230	Intraoral - periapical each additional radiographic image	34,780	$20	$521.7K

Showing 1–10 of 34

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Hawaii providers billing the same CPT/HCPCS codes.

Claims Volume vs. Hawaii Distribution

Hawaii Dental Group, Inc. — 18 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Hawaii

Full comparison — all codes billed, vs. Hawaii median

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D7240	N/A	10	10	310	$280	$348.8K
D2930	N/A	1	30	850	$100	$168.5K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	5	30	310	$150	$157.6K
D0140	Limited oral evaluation – problem focused	7	120	400	$140	$150.2K
D7230	N/A	5	10	400	$230	$122.4K
D9230	N/A	1	40	980	$60	$115K
D1120	Prophylaxis–child	1	120	600	$30	$109.9K
D0120	Periodic oral evaluation - established patient	1	140	600	$30	$97.1K
D2392	Post 2 surface resin‑based composite	1	60	370	$80	$78.4K
D0240	N/A	10	10	460	$20	$69.9K

Showing 1–10 of 34

Nearby Providers

Other providers in the same ZIP code as Hawaii Dental Group, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Queens Medical Center	HI	General Acute Care Hospital	$0	$200M
Straub Clinic & Hospital	HI	General Acute Care Hospital	$0	$45.6M
State Of Hawaii Dept. Of Health Adult Mental Health Division	HI	Community/Behavioral Health Agency	$0	$29.3M
Positive Behavior Supports Corporation	HI	Community/Behavioral Health Agency	$0	$26.4M
Easter Seals Hawaii	HI	Developmentally Disabled Services Day Training Agency	$0	$16.8M
The Emergency Group, Inc.	HI	Emergency Medicine Physician	$0	$15M
The Queen's Medical Center	HI	General Acute Care Hospital	$0	$10.3M
Hawaii Home Care Inc	HI	Nursing Care Agency	$0	$9.3M
Evergreen Adult Day Care	HI	Adult Day Care Clinic/Center	$0	$8.9M
Straub Clinic & Hospital	HI	Multi-Specialty Clinic/Center	$0	$8.2M

Hawaii Dental Group, Inc. — Billing Profile & Reimbursement Data

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Hawaii Dental Group, Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References