Clinic
Fleetwood Square Dental, LLC
Fleetwood Square Dental, LLC was paid $350K by Medicaid between Oct 2020 and Dec 2024, across 14 billing codes. Its largest line is D1110, Prophylaxis - adult — 24% of everything it billed.
33Billing provider infoFLEETWOOD SQUARE DENTAL, LLC
EASLEY, SC 29640
EASLEY, SC 29640
33aNPI1831700178assigned 08/11/2020
33bProvider typeDental Clinic/Center
28Total paid$350K
24GClaims9,414
24DCodes billed14
24AFirst – last monthOct 2020 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in South Carolina
Rank by total paid#28 of 68
Median peer was paid$121K
This provider vs. median2.9×
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 | 184 | $6K | |
| 2021 | 1,323 | $41K | |
| 2022 | 2,181 | $73K | |
| 2023 | 2,720 | $98K | |
| 2024incomplete | 3,006 | $132K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 24% | 1,726 | 1,726 | $83K |
| D0150 | Comprehensive oral evaluation - new or established patient | 17% | 1,568 | 1,568 | $59K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 16% | 612 | 376 | $55K |
| D0274 | Bitewings - four radiographic images | 16% | 2,076 | 2,076 | $55K |
| D0330 | Panoramic radiographic image | 13% | 944 | 944 | $44K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 4.7% | 734 | 734 | $16K |
| D1208 | Topical application of fluoride, excluding varnish | 3.4% | 742 | 742 | $12K |
| D0220 | Intraoral - periapical first radiographic image | 2.2% | 668 | 654 | $8K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 1.6% | 54 | 25 | $6K |
| D0140 | Limited oral evaluation - problem focused | 1.4% | 141 | 141 | $5K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.3% | 56 | 37 | $5K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 14 | 13 | $1K |
2 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 officialKAKKAR, SONIA (MBR)