Clinic
Powdersville Family Dentistry, LLC
Powdersville Family Dentistry, LLC was paid $17K by Medicaid between Feb 2018 and Jan 2022, across 7 billing codes. Its largest line is D1110, Prophylaxis - adult — 29% of everything it billed.
33Billing provider infoPOWDERSVILLE FAMILY DENTISTRY, LLC
POWDERSVILLE, SC 29673
POWDERSVILLE, SC 29673
33aNPI1326554841assigned 12/19/2017
33bProvider typeDental Clinic/Center
28Total paid$17K
24GClaims549
24DCodes billed7
24AFirst – last monthFeb 2018 – Jan 2022
Compared with peers
Next to other Dental Clinic/Center providers in South Carolina
Rank by total paid#53 of 68
Median peer was paid$121K
This provider vs. median0.1×
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 | 87 | $3K | |
| 2019 | 226 | $7K | |
| 2020 | 152 | $5K | |
| 2021 | 57 | $1K | |
| 2022 | 27 | $529.20 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 29% | 97 | 97 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | 26% | 108 | 108 | $4K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 25% | 187 | 187 | $4K |
| D0272 | Bitewings - two radiographic images | 7.4% | 65 | 65 | $1K |
| D1120 | Dental cleaning, childProphylaxis - child | 5.5% | 26 | 26 | $904.80 |
| D1206 | Topical application of fluoride varnish | 5.3% | 54 | 54 | $874.80 |
| D0274 | Bitewings - four radiographic images | 2.0% | 12 | 12 | $330.12 |
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 officialKENNEDY, JOHN (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Stepping Stones Family Counseling | Richfield, UT | $94K |
| D &L K INC | Marion, IN | $60K |
| Capitol Cardiologic, LLP | Annapolis, MD | $48K |
| Kennedy Ophthalmology Associates PLLC | Schenectady, NY | $5K |
| John M. Kennedy, M.D., INC. | Torrance, CA | $2K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.