Dental
Upstate Pediatric Dentistry, PA
Upstate Pediatric Dentistry, PA was paid $5.31M by Medicaid between Jan 2018 and Dec 2024, across 23 billing codes. Its largest line is D1120, dental cleaning, child — 22% of everything it billed.
33Billing provider infoUPSTATE PEDIATRIC DENTISTRY, PA
GREENVILLE, SC 29607
GREENVILLE, SC 29607
33aNPI1275780454assigned 08/19/2008
33bProvider typePediatric Dentist
28Total paid$5.31M
24GClaims171,174
24DCodes billed23
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in South Carolina
Rank by total paid#12 of 86
Median peer was paid$1.24M
This provider vs. median4.3×
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 | 22,952 | $750K | |
| 2019 | 25,893 | $832K | |
| 2020 | 21,264 | $642K | |
| 2021 | 27,175 | $863K | |
| 2022 | 26,223 | $779K | |
| 2023 | 23,739 | $654K | |
| 2024incomplete | 23,928 | $790K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 22% | 33,503 | 33,502 | $1.18M |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 16% | 35,957 | 35,956 | $848K |
| D1206 | Topical application of fluoride varnish | 12% | 38,766 | 38,765 | $638K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 7.6% | 3,163 | 1,237 | $406K |
| D1110 | Prophylaxis - adult | 6.5% | 6,781 | 6,781 | $343K |
| D0272 | Bitewings - two radiographic images | 5.6% | 15,494 | 15,494 | $296K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 5.5% | 2,816 | 1,961 | $294K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.6% | 2,891 | 1,999 | $243K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 4.4% | 7,091 | 6,891 | $231K |
| D0330 | Panoramic radiographic image | 3.0% | 3,147 | 3,147 | $159K |
| D1351 | Sealant - per tooth | 2.5% | 4,293 | 1,153 | $131K |
| D0140 | Limited oral evaluation - problem focused | 2.4% | 3,250 | 3,195 | $126K |
11 more codes
| D7140 | Extraction, erupted tooth or exposed root | 2.4% | 1,367 | $125K |
| D0145 | Oral evaluation for a patient under three years of age | 1.7% | 2,001 | $89K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.3% | 1,632 | $67K |
| D0220 | Intraoral - periapical first radiographic image | 1.1% | 4,446 | $57K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 3,208 | $30K |
| D0240 | <1% | 941 | $17K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 190 | $16K |
| D9420 | <1% | 104 | $9K | |
| D9248 | <1% | 65 | $4K | |
| D2330 | <1% | 47 | $3K | |
| D2332 | <1% | 21 | $2K |
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 officialJONES, BRIAN (DENTIST)
| Provider | Location | Paid |
|---|---|---|
| South Arkansas Regional Hospital LLC | El Dorado, AR | $766K |
| South Arkansas Physician Group LLC | El Dorado, AR | $44K |
| Defining Purpose Counseling and Consulting LLC | Newport News, VA | $39K |
| Shoreline Physical Therapy | Haleiwa, HI | $4K |
| Father Bob Allen Charitable Clinic | El Dorado, AR | $2K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.