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    OpenPayerNPI Medicare & MedicaidMidlands Pediatric Dentistry LLC
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    Midlands Pediatric Dentistry LLC — Billing Profile & Reimbursement Data

    NPI 1841667037 · Lexington, SC · Pediatric Dentistry

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    Midlands Pediatric Dentistry LLC is a pediatric dentistry provider located in Lexington, South Carolina. This profile covers 0 Medicare and 24 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationMidlands Pediatric Dentistry LLC
    Address253 Cedarcrest Dr
    CityLexington
    StateSC
    ZIP29072
    TaxonomyPediatric Dentistry
    NPI EnumeratedAugust 24, 2015

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$2.8M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    24 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    D2930N/A3,220$130$402.6K
    D1120Prophylaxis–child10,930$40$382.6K
    D0120Periodic oral evaluation - established patient11,750$20$270.2K
    D2393Resin-based composite, three surfaces, posterior1,630$120$202.1K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)2,130$90$193.9K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients11,560$20$184.9K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth3,580$50$178.8K
    D3220N/A1,990$80$165.1K
    D0272N/A5,940$20$112.9K
    D9230N/A3,060$30$97.8K

    Showing 1–10 of 24

    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.

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

    24 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    D2930N/A331301,060$150$371.1K
    D2392Post 2 surface resin‑based composite143350520$100$175.3K
    D1120Prophylaxis–child51470600$30$156.7K
    D9248N/A3350920$70$126.1K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)49290380$90$125K
    D9230N/A662101,150$30$115.5K
    D1351Sealant - per tooth189200840$30$108.9K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth83590850$50$104.9K
    D0120Periodic oral evaluation - established patient566101,060$20$100K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients52410670$20$95.1K

    Showing 1–10 of 24

    Nearby Providers

    Other providers in the same ZIP code as Midlands Pediatric Dentistry LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Southern Medical Management, LLCSCPediatrics Physician$0$43.9M
    Allcaregivers, Inc.SCNursing Care Agency$0$33.3M
    South Carolina Dept Of Mental Health Accounting OfficeSCMental Health Clinic/Center (Including Community Mental Health Center)$0$32M
    Lexington County EmsSCAmbulance$2.9M$6.9M
    Lexington Health IncSCUrgent Care Clinic/Center$0$8.7M
    Key Care Health Services, LLCSCHome Health Agency$0$8.5M
    Capital City Therapy Group, LLCSCSpecialist$0$7.3M
    Health Promotion SpecialistsSCDental Hygienist$0$6.5M
    Lexington School District OneSCLocal Education Agency (LEA)$0$5.7M
    Lexington Health IncSCPediatric Adolescent Medicine Physician$0$5.7M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. South Carolina Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. South Carolina Distribution
    Midlands Pediatric Dentistry LLC — 0 of 24 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Carolina