Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › SC › POWDERSVILLE › POWDERSVILLE FAMILY DENTISTRY, LLC

POWDERSVILLE FAMILY DENTISTRY, LLC

NPI: 1326554841 · POWDERSVILLE, SC 29673 · Dental Clinic/Center · NPI assigned 12/19/2017

$17K
Total Medicaid Paid
549
Total Claims
549
Beneficiaries
7
Codes Billed
2018-02
First Month
2022-01
Last Month

Provider Details

Authorized OfficialKENNEDY, JOHN (OWNER)
NPI Enumeration Date12/19/2017

Related Entities

Other providers sharing the same authorized official: KENNEDY, JOHN

ProviderCityStateTotal 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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 87 $3K
2019 226 $7K
2020 152 $5K
2021 57 $1K
2022 27 $529.20

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 97 97 $5K
D0150 Comprehensive oral evaluation - new or established patient 108 108 $4K
D0120 Periodic oral evaluation - established patient 187 187 $4K
D0272 Bitewings - two radiographic images 65 65 $1K
D1120 Prophylaxis - child 26 26 $904.80
D1206 Topical application of fluoride varnish 54 54 $874.80
D0274 Bitewings - four radiographic images 12 12 $330.12