Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or South Carolina for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to South Carolina only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. South Carolina (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Dentistry For Children Of South Carolina, PC (NPI 1669726048)

Field	Value
Entity Type	Organization
Organization	Dentistry For Children Of South Carolina, PC
Address	808 Wappoo Rd
City	Charleston
State	SC
ZIP	29407
Taxonomy	Pediatric Dentistry
NPI Enumerated	November 6, 2012

Payer Source	Total Paid
Medicaid	$68.4M
Medicare	$0

Key Findings

This practice is effectively a single‑payer Medicaid operator: total Medicaid revenue is $68.4M and there is no Medicare billing on file, so Medicaid drives the entirety of observed public‑payer activity and financial scale. Analysts should treat Medicaid reimbursement patterns as the principal business signal for this entity.

Revenue is highly concentrated in a small set of procedures: the precomputed top 3 Medicaid codes by revenue account for 35.9% of this provider's total Medicaid revenue. Those top contributors are D1120 (269.5K claims, $35 avg paid/claim, $9.4M revenue; 13.8%), D0120 (330.6K claims, $24 avg paid/claim, $7.9M revenue; 11.6%), and D2392 (69.4K claims, $103 avg paid/claim, $7.2M revenue; 10.5%).

The code mix indicates a high‑volume pediatric preventive and restorative operation: D1120 (Prophylaxis–child), D0120 (Periodic oral evaluation), and D1206 (Topical Fluoride Treatment) appear among the highest‑volume codes, while D2392, D2391 and D2930 show substantial restorative work. This combination—large counts of prophylaxis, fluoride, sealants (D1351), and posterior composite restorations—is consistent with a practice focused on routine pediatric dental care and high throughput preventive/restorative services.

Competitive standing in South Carolina is dominant for many codes: the provider ranks #1 in‑state and at the 100th percentile as an “extreme outlier” for multiple high‑volume items (for example, D1120 is #1 of 473 providers, D0120 is #1 of 606 providers, and D2392 is #1 of 347 providers). These rank/percentile labels indicate this entity is far above typical state volume for core pediatric services and likely captures a disproportionate share of Medicaid pediatric dental claims in the Charleston area.

The practice reports very large claim volumes across several codes, signaling substantial throughput: D1206 shows 356.8K claims, D0120 330.6K claims, and D1120 269.5K claims, each contributing millions in revenue. Those raw volumes, coupled with high in‑state ranks, imply operational scale that exceeds typical independent pediatric offices and will materially affect payer utilization profiles in the region.

Notable presence of adult/other codes appears in the mix: D1110 (Prophylaxis - adult) accounts for 113K claims and $5.8M revenue (8.4% of Medicaid revenue), which is sizeable given the provider’s Pediatric Dentistry taxonomy. The inclusion of D1110 alongside pediatric codes suggests either enrollment of older adolescents/young adults under the same TIN or billing patterns that extend beyond strictly child‑only preventive visits, and this should be considered when profiling patient age mix and service lines.

High‑value restorative and surgical procedures contribute meaningful revenue per claim: D2392 has an $103 avg paid/claim, D2930 has a $127 avg paid/claim, and D7140 has a $95 avg paid/claim, each generating multi‑million dollar totals. These rates show that beyond very high preventive volumes, the provider also captures significant revenue from higher‑paid restorative and extraction procedures, supporting a mixed preventive/restorative revenue model.

The provider has an established NPI tenure (enumerated 2012-11-06 (~14 years ago)), and when combined with its extreme‑outlier in‑state ranks across many codes, this suggests a sustained, market‑leading presence in Medicaid pediatric dental services rather than a short‑term or incidental billing pattern. Payers evaluating network adequacy or concentrating outreach should consider this long tenure and consistent high volumes as evidence of an entrenched regional provider.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

37 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1120	Prophylaxis–child	269,530	$40	$9.4M
D0120	Periodic oral evaluation - established patient	330,640	$20	$7.9M
D2392	Post 2 surface resin‑based composite	69,450	$100	$7.2M
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	112,970	$50	$5.8M
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	356,780	$20	$5.7M
D2930	N/A	42,810	$130	$5.4M
D2391	Resin‑based composite – one surface, posterior	51,620	$80	$4.3M
D9230	N/A	115,960	$30	$3.7M
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	31,700	$100	$3M
D0272	N/A	156,880	$20	$3M

Showing 1–10 of 37

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other South Carolina providers billing the same CPT/HCPCS codes.

Claims Volume vs. South Carolina Distribution

Dentistry For Children Of South Carolina, PC — 22 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. South Carolina median

37 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	1	130	1,060	$150	$371.1K
D7240	N/A	52	60	450	$260	$370K
D2392	Post 2 surface resin‑based composite	1	350	520	$100	$175.3K
D1120	Prophylaxis–child	1	470	600	$30	$156.7K
D9248	N/A	3	50	920	$70	$126.1K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	1	290	380	$90	$125K
D9230	N/A	1	210	1,150	$30	$115.5K
D2391	Resin‑based composite – one surface, posterior	1	300	270	$80	$110.5K
D1351	Sealant - per tooth	2	200	840	$30	$108.9K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	1	590	850	$50	$104.9K

Showing 1–10 of 37

Nearby Providers

Other providers in the same ZIP code as Dentistry For Children Of South Carolina, PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medcare Express - North Charleston LLC	SC	Urgent Care Clinic/Center	$0	$34.8M
Justiceworks Behavioral Care	SC	Community/Behavioral Health Agency	$0	$18.6M
Carolina Health Force	SC	Nursing Care Agency	$0	$8.8M
Plantation Pediatrics, LLC	SC	Pediatrics Physician	$0	$8.2M
Southern Home Care Services, Inc.	SC	In Home Supportive Care Agency	$0	$5.8M
Charleston Pediatric Rehabilitation LLC	SC	Speech-Language Pathologist	$0	$3.8M
Charleston Ent Associates, LLC	SC	Ambulatory Surgical Clinic/Center	$482K	$2.8M
Charleston Ot LLC	SC	Occupational Therapist	$0	$3.2M
Active Sc One, Inc.	SC	Adult Day Care Clinic/Center	$0	$3.2M
Personal Care, Inc.	SC	Land Ambulance	$2.7M	$234.3K

Dentistry For Children Of South Carolina, PC — Billing Profile & Reimbursement Data

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Dentistry For Children Of South Carolina, PC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References