Dental
Family Dental Health of Cleveland Street, LLC
Family Dental Health of Cleveland Street, LLC was paid $24K by Medicaid between Jun 2020 and Apr 2024, across 9 billing codes. Its largest line is D1110, Prophylaxis - adult — 30% of everything it billed.
33Billing provider infoFAMILY DENTAL HEALTH OF CLEVELAND STREET, LLC
GREENVILLE, SC 29607
GREENVILLE, SC 29607
33aNPI1619325107assigned 05/25/2016
33bProvider typeGeneral Practice Dentistry
28Total paid$24K
24GClaims782
24DCodes billed9
24AFirst – last monthJun 2020 – Apr 2024
Compared with peers
Next to other General Practice Dentistry providers in South Carolina
Rank by total paid#211 of 331
Median peer was paid$75K
This provider vs. median0.3×
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 | |
|---|---|---|---|
| 2020 | 198 | $7K | |
| 2021 | 115 | $4K | |
| 2022 | 273 | $9K | |
| 2023 | 172 | $4K | |
| 2024incomplete | 24 | $537.80 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 30% | 146 | 146 | $7K |
| D0150 | Comprehensive oral evaluation - new or established patient | 24% | 151 | 151 | $6K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 15% | 165 | 165 | $4K |
| D1206 | Topical application of fluoride varnish | 11% | 170 | 170 | $3K |
| D1120 | Dental cleaning, childProphylaxis - child | 6.9% | 48 | 48 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.5% | 21 | 13 | $1K |
| D0140 | Limited oral evaluation - problem focused | 3.9% | 26 | 26 | $946.60 |
| D0220 | Intraoral - periapical first radiographic image | 2.2% | 43 | 43 | $542.04 |
| D0274 | Bitewings - four radiographic images | 1.4% | 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 officialSAFRIT, BOBBY (OWNER)
Parent organizationFDH HOLDINGS
| Provider | Location | Paid |
|---|---|---|
| Family Dental Health of Easley, LLC | Easley, SC | $526K |
| Family Dental Health of Mauldin LLC | Mauldin, SC | $359K |
| Family Dental Health of Reidville Circle, LLC | Spartanburg, SC | $112K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.