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 Alabama for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Alabama 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. Alabama (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.

Pediatric Smiles (NPI 1003136615)

Field	Value
Entity Type	Organization
Organization	Pediatric Smiles
Address	5751 Pocahontas Road
City	Bessemer
State	AL
ZIP	35022
Taxonomy	Pediatric Dentistry
NPI Enumerated	June 4, 2010

Payer Source	Total Paid
Medicaid	$5.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2930	N/A	14,460	$50	$780.8K
D1120	Prophylaxis–child	30,920	$20	$742K
D0120	Periodic oral evaluation - established patient	33,450	$20	$568.6K
D1208	Topical application of fluoride - excluding varnish	34,970	$10	$454.6K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	10,330	$40	$361.4K
D2391	Resin‑based composite – one surface, posterior	6,830	$50	$327.9K
D1999	N/A	16,880	$20	$287K
D2392	Post 2 surface resin‑based composite	4,660	$60	$284K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	6,900	$30	$220.9K
D0272	N/A	12,130	$20	$181.9K

Showing 1–10 of 26

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

Pediatric Smiles — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	3	120	1,240	$90	$233.9K
D2392	Post 2 surface resin‑based composite	34	280	520	$70	$144.9K
D9420	N/A	11	20	230	$170	$110.9K
D1120	Prophylaxis–child	11	520	810	$30	$104.3K
D2391	Resin‑based composite – one surface, posterior	15	250	380	$60	$91.8K
D1999	N/A	27	300	1,280	$20	$81.5K
D0120	Periodic oral evaluation - established patient	20	620	810	$20	$77.2K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	2	190	490	$50	$76.2K
D3220	N/A	8	60	350	$70	$70.1K
D1351	Sealant - per tooth	67	180	710	$20	$63.3K

Showing 1–10 of 26

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medical West Hospital Authority, An Affiliate Of Uab Health System	AL	General Acute Care Hospital	$0	$11.4M
Bessemer Emergency Physicians, LLC.	AL	Emergency Medicine Physician	$0	$4.7M
Babi Pediatrics,pc Dba Peds459	AL	Primary Care Clinic/Center	$0	$2.5M
Northstar Ems, Inc.	AL	Land Ambulance	$155.6K	$1M
Joanne Rossman	AL	Hematology & Oncology Physician	$874.6K	$0
Michael Burch	AL	Hospitalist Physician	$311K	$0
Sadri Avsar	AL	Physical Medicine & Rehabilitation Physician	$299.9K	$0
Mohannad Azzam	AL	Internal Medicine Physician	$282.3K	$0
Ttc, LLC	AL	Substance Use Disorder Rehabilitation Clinic/Center	$215.8K	$0
Leigh Ann Clanton	AL	Family Nurse Practitioner	$91.3K	$0

Pediatric Smiles — Billing Profile & Reimbursement Data

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Pediatric Smiles — Billing Profile & Reimbursement Data

Sign up for Pediatric Smiles — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References