Clinic
Prime Pediatric Dentistry
Prime Pediatric Dentistry was paid $2.85M by Medicaid between Feb 2018 and Jun 2022, across 28 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 27% of everything it billed.
33Billing provider infoPRIME PEDIATRIC DENTISTRY
FLORENCE, SC 29501
FLORENCE, SC 29501
33aNPI1811405400assigned 01/17/2018
33bProvider typeDental Clinic/Center
28Total paid$2.85M
24GClaims60,167
24DCodes billed28
24AFirst – last monthFeb 2018 – Jun 2022
Compared with peers
Next to other Dental Clinic/Center providers in South Carolina
Rank by total paid#11 of 68
Median peer was paid$121K
This provider vs. median24×
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 | 7,186 | $354K | |
| 2019 | 16,061 | $864K | |
| 2020 | 14,308 | $673K | |
| 2021 | 21,029 | $822K | |
| 2022 | 1,583 | $139K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 27% | 6,409 | 2,152 | $778K |
| D2934 | 10% | 2,321 | 547 | $289K | |
| D7140 | Extraction, erupted tooth or exposed root | 7.3% | 2,480 | 1,323 | $208K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 6.5% | 2,362 | 1,134 | $186K |
| D1120 | Dental cleaning, childProphylaxis - child | 5.9% | 5,234 | 5,234 | $169K |
| D9248 | 5.0% | 2,271 | 2,168 | $142K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 4.2% | 1,222 | 815 | $121K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.3% | 3,120 | 2,969 | $95K |
| D0140 | Limited oral evaluation - problem focused | 3.2% | 2,504 | 2,487 | $93K |
| D1206 | Topical application of fluoride varnish | 3.1% | 5,973 | 5,973 | $90K |
| D0272 | Bitewings - two radiographic images | 2.9% | 4,595 | 4,595 | $82K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.8% | 1,034 | 733 | $79K |
16 more codes
| D9420 | 2.6% | 888 | $75K | |
| D0120 | Dental checkup, returning patient | 2.5% | 3,418 | $71K |
| D1351 | Sealant - per tooth | 2.1% | 2,139 | $60K |
| D0220 | Intraoral - periapical first radiographic image | 2.0% | 4,721 | $57K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.7% | 1,248 | $48K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.5% | 4,726 | $44K |
| D1110 | Prophylaxis - adult | 1.4% | 902 | $41K |
| D2330 | 1.2% | 500 | $33K | |
| D9920 | <1% | 390 | $20K | |
| D0330 | Panoramic radiographic image | <1% | 391 | $18K |
| D0274 | Bitewings - four radiographic images | <1% | 668 | $16K |
| D1510 | <1% | 95 | $16K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 452 | $16K |
| D2932 | <1% | 44 | $7K | |
| D9992 | <1% | 35 | $855.34 | |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 25 | $405.00 |
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 officialBOUROGYNE, KATHY (OFFICE MANAGER)