Dental
Powdersville Pediatric Dentistry, PA
Powdersville Pediatric Dentistry, PA was paid $180K by Medicaid between Jan 2018 and Aug 2019, across 16 billing codes. Its largest line is D1120, dental cleaning, child — 16% of everything it billed.
33Billing provider infoPOWDERSVILLE PEDIATRIC DENTISTRY, PA
EASLEY, SC 29642
EASLEY, SC 29642
33aNPI1417965922assigned 08/03/2006
33bProvider typePediatric Dentist
28Total paid$180K
24GClaims5,983
24DCodes billed16
24AFirst – last monthJan 2018 – Aug 2019
Compared with peers
Next to other Pediatric Dentist providers in South Carolina
Rank by total paid#69 of 86
Median peer was paid$1.24M
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 | 3,348 | $96K | |
| 2019 | 2,635 | $84K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 16% | 822 | 822 | $29K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 12% | 929 | 929 | $21K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 11% | 197 | 140 | $20K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 11% | 614 | 558 | $19K |
| D1208 | Topical application of fluoride, excluding varnish | 11% | 1,184 | 1,184 | $19K |
| D1110 | Prophylaxis - adult | 10% | 381 | 381 | $18K |
| D1351 | Sealant - per tooth | 7.3% | 458 | 159 | $13K |
| D0272 | Bitewings - two radiographic images | 6.4% | 624 | 624 | $12K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.4% | 114 | 78 | $8K |
| D0274 | Bitewings - four radiographic images | 3.5% | 237 | 237 | $6K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.0% | 135 | 135 | $5K |
| D9248 | 1.5% | 45 | 40 | $3K |
4 more codes
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 officialRICHARDS, MELANIE (OWNER PRESIDENT)