Williamston Family Dental, LLC

Williamston Family Dental, LLC was paid $44K by Medicaid between Jan 2018 and Jul 2018, across 10 billing codes. Its largest line is D1110, Prophylaxis - adult — 23% of everything it billed.

33Billing provider infoWILLIAMSTON FAMILY DENTAL, LLC
WILLIAMSTON, SC 29697

33aNPI1003253758assigned 06/03/2013

33bProvider typeDentist

28Total paid$44K

24GClaims1,107

24DCodes billed10

24AFirst – last monthJan 2018 – Jul 2018

Compared with peers

Next to other Dentist providers in South Carolina

Rank by total paid#92 of 166

Median peer was paid$67K

This provider vs. median0.7×

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	1,107	$44K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	23%	200	200	$10K
D2391	Resin-based composite - one surface, posterior, primary or permanent	18%	103	66	$8K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	14%	62	41	$6K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	9.9%	188	188	$4K
D1208	Topical application of fluoride, excluding varnish	8.2%	223	223	$4K
D0150	Comprehensive oral evaluation - new or established patient	7.2%	79	79	$3K
D1120	Dental cleaning, childProphylaxis - child	6.9%	86	86	$3K
D7140	Extraction, erupted tooth or exposed root	6.7%	34	16	$3K
D0272	Bitewings - two radiographic images	4.1%	95	95	$2K
D0274	Bitewings - four radiographic images	2.3%	37	37	$1K

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 officialDEBANY, JODY (OFFICE MANAGER)