Dental
Indigo Pediatric Dentistry
Indigo Pediatric Dentistry was paid $1.78M by Medicaid between Mar 2019 and Dec 2024, across 22 billing codes. Its largest line is D1120, dental cleaning, child — 18% of everything it billed.
33Billing provider infoINDIGO PEDIATRIC DENTISTRY
EASLEY, SC 29642
EASLEY, SC 29642
33aNPI1174082713assigned 03/13/2019
33bProvider typePediatric Dentist
28Total paid$1.78M
24GClaims54,903
24DCodes billed22
24AFirst – last monthMar 2019 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in South Carolina
Rank by total paid#36 of 86
Median peer was paid$1.24M
This provider vs. median1.4×
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 | 7,499 | $268K | |
| 2020 | 5,042 | $165K | |
| 2021 | 9,889 | $296K | |
| 2022 | 11,576 | $368K | |
| 2023 | 10,376 | $308K | |
| 2024incomplete | 10,521 | $373K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 18% | 9,390 | 9,321 | $319K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 12% | 2,080 | 1,406 | $212K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 12% | 9,004 | 8,929 | $206K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 12% | 1,638 | 738 | $206K |
| D1206 | Topical application of fluoride varnish | 9.4% | 10,482 | 10,401 | $168K |
| D7140 | Extraction, erupted tooth or exposed root | 6.1% | 1,159 | 568 | $108K |
| D0272 | Bitewings - two radiographic images | 5.5% | 5,333 | 5,299 | $98K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 5.0% | 2,851 | 2,738 | $89K |
| D1110 | Prophylaxis - adult | 3.5% | 1,314 | 1,302 | $63K |
| D1351 | Sealant - per tooth | 2.5% | 1,581 | 625 | $45K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.4% | 1,101 | 1,100 | $43K |
| D0145 | Oral evaluation for a patient under three years of age | 2.3% | 770 | 770 | $42K |
10 more codes
| D0220 | Intraoral - periapical first radiographic image | 2.2% | 3,102 | $39K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 2.1% | 457 | $37K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.3% | 2,311 | $24K |
| D0140 | Limited oral evaluation - problem focused | 1.2% | 565 | $21K |
| D0330 | Panoramic radiographic image | <1% | 368 | $18K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 232 | $18K |
| D1354 | <1% | 987 | $11K | |
| D9310 | <1% | 120 | $7K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 36 | $4K |
| D7111 | <1% | 22 | $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 officialSHALABI, RULA (OWNER, PEDIATRIC DENTIST)