Dental
Spartanburg Pediatric Dentistry
Spartanburg Pediatric Dentistry was paid $2.67M by Medicaid between Jan 2018 and Dec 2024, across 28 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 17% of everything it billed.
33Billing provider infoSPARTANBURG PEDIATRIC DENTISTRY
SPARTANBURG, SC 29307
SPARTANBURG, SC 29307
33aNPI1083934202assigned 06/10/2010
33bProvider typePediatric Dentist
28Total paid$2.67M
24GClaims68,443
24DCodes billed28
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in South Carolina
Rank by total paid#28 of 86
Median peer was paid$1.24M
This provider vs. median2.2×
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 | 10,598 | $438K | |
| 2019 | 10,382 | $430K | |
| 2020 | 8,135 | $316K | |
| 2021 | 11,291 | $415K | |
| 2022 | 9,887 | $372K | |
| 2023 | 7,641 | $226K | |
| 2024incomplete | 10,509 | $469K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 17% | 3,569 | 975 | $441K |
| D1120 | Dental cleaning, childProphylaxis - child | 12% | 9,583 | 9,583 | $332K |
| D7140 | Extraction, erupted tooth or exposed root | 12% | 3,311 | 1,064 | $324K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 9.7% | 2,509 | 979 | $259K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.3% | 8,353 | 8,353 | $194K |
| D1206 | Topical application of fluoride varnish | 7.1% | 11,666 | 11,666 | $190K |
| D0272 | Bitewings - two radiographic images | 5.7% | 8,033 | 8,033 | $151K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.8% | 2,487 | 2,487 | $101K |
| D1110 | Prophylaxis - adult | 3.6% | 1,938 | 1,938 | $97K |
| D1351 | Sealant - per tooth | 3.5% | 3,137 | 991 | $93K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.7% | 2,283 | 2,209 | $72K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 2.4% | 824 | 348 | $64K |
16 more codes
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | 1.7% | 491 | $44K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.6% | 488 | $42K |
| D0220 | Intraoral - periapical first radiographic image | 1.6% | 3,319 | $42K |
| D0330 | Panoramic radiographic image | 1.3% | 680 | $34K |
| D9222 | 1.3% | 381 | $34K | |
| D0145 | Oral evaluation for a patient under three years of age | 1.1% | 809 | $30K |
| D9310 | 1.1% | 447 | $28K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 2,272 | $23K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 405 | $21K |
| D0140 | Limited oral evaluation - problem focused | <1% | 432 | $17K |
| D0240 | <1% | 827 | $16K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 50 | $6K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | <1% | 52 | $4K |
| D9420 | <1% | 39 | $4K | |
| D2330 | <1% | 25 | $2K | |
| D1354 | <1% | 33 | $495.00 |
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 officialBIRCH, CHARLES (OWNER)