Dental
Pedo Carolina, INC.
Pedo Carolina, INC. was paid $2.74M by Medicaid between Apr 2018 and Dec 2024, across 24 billing codes. Its largest line is D1120, dental cleaning, child — 20% of everything it billed.
33Billing provider infoPEDO CAROLINA, INC.
ROCK HILL, SC 29732
ROCK HILL, SC 29732
33aNPI1770918351assigned 09/13/2013
33bProvider typePediatric Dentist
28Total paid$2.74M
24GClaims82,854
24DCodes billed24
24AFirst – last monthApr 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in South Carolina
Rank by total paid#27 of 86
Median peer was paid$1.24M
This provider vs. median2.2×
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 | 41 | $981.40 | |
| 2019 | 1,100 | $36K | |
| 2020 | 827 | $23K | |
| 2021 | 22,205 | $748K | |
| 2022 | 21,828 | $692K | |
| 2023 | 18,741 | $595K | |
| 2024incomplete | 18,112 | $640K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 20% | 15,555 | 15,555 | $546K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 13% | 15,022 | 15,022 | $357K |
| D1206 | Topical application of fluoride varnish | 10% | 16,913 | 16,913 | $280K |
| D7140 | Extraction, erupted tooth or exposed root | 9.3% | 2,438 | 1,480 | $255K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 8.3% | 1,767 | 993 | $228K |
| D9248 | 4.5% | 1,691 | 1,683 | $122K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 3.7% | 1,226 | 807 | $101K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.7% | 3,132 | 3,099 | $101K |
| D1110 | Prophylaxis - adult | 3.5% | 1,888 | 1,888 | $95K |
| D0330 | Panoramic radiographic image | 3.3% | 1,745 | 1,745 | $89K |
| D0145 | Oral evaluation for a patient under three years of age | 2.8% | 1,440 | 1,440 | $78K |
| D0274 | Bitewings - four radiographic images | 2.8% | 2,670 | 2,670 | $76K |
12 more codes
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 2.6% | 689 | $72K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.2% | 1,443 | $60K |
| D1351 | Sealant - per tooth | 2.2% | 1,986 | $60K |
| D0272 | Bitewings - two radiographic images | 2.0% | 2,837 | $54K |
| D0220 | Intraoral - periapical first radiographic image | 1.9% | 4,072 | $53K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.8% | 4,650 | $49K |
| D0140 | Limited oral evaluation - problem focused | 1.4% | 968 | $37K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 106 | $10K |
| D9420 | <1% | 75 | $6K | |
| D1354 | <1% | 517 | $5K | |
| D7111 | <1% | 12 | $804.00 | |
| D9920 | <1% | 12 | $770.00 |
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 officialMITCHELL, JONATHAN (PRESIDENT/OWNER)
| Provider | Location | Paid |
|---|---|---|
| Alberta Professional Services | Greensboro, NC | $1.30M |
| Jonathan Mitchell, LLC | Lexington, KY | $120K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.