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

Why is the Medicaid comparison limited to South Dakota 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 Dakota (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.

Dakota Dental 4 Kids (NPI 1023660719)

Field	Value
Entity Type	Organization
Organization	Dakota Dental 4 Kids
Address	5509 Bendt Dr Ste 302
City	Rapid City
State	SD
ZIP	57702
Taxonomy	Dental Clinic/Center
NPI Enumerated	July 12, 2019

Payer Source	Total Paid
Medicaid	$7.1M
Medicare	$0

Key Findings

DAKOTA DENTAL 4 KIDS is effectively a single‑payer Medicaid outpatient dental operator: there is no Medicare billing on file while lifetime Medicaid revenue is $7.1M, so analytics and contracting discussions should treat Medicaid as the primary and only evidenced payer relationship. This concentration means payer‑mix risk and growth opportunities will be driven almost entirely by Medicaid policy and managed‑care arrangements in South Dakota.

Revenue is highly concentrated in a few procedure lines: the precomputed top 3 Medicaid codes account for 40.2% of the provider's total Medicaid revenue, with D2930 alone representing 23.9% ($1.6M), followed by D1351 at 9.8% ($664.4K) and D9223 at 6.5% ($444K). Any reimbursement changes or utilization shifts for these codes would therefore have outsized impact on the provider's topline.

The code mix indicates a strong preventive and pediatric focus: high volumes and revenue for D1351 (Sealant - per tooth) with 19.5K claims and $664.4K revenue, D1120 (Prophylaxis–child) with 8.4K claims and $369.9K, and D1206 (Topical Fluoride Treatment) with 12.3K claims and $319.4K. That combination of sealants, child prophylaxis and fluoride services is characteristic of clinics organized around school‑age preventive programs and routine pediatric recall visits.

While preventive care is a clear strength, the practice also delivers restorative and surgical services at scale: D7140 (extraction) produced $424.7K from 4.4K claims and restorative codes such as D2150, D2140 and D2391 together contribute meaningful revenue ($284.1K, $196.3K, $186.6K respectively). This breadth—preventive plus extractions and restorations—supports positioning as a full‑service dental clinic for a pediatric population rather than a narrow preventive clinic.

Competitive standing within South Dakota is uneven by code: the practice ranks highly on several preventive codes — D1351 is #3 of 50 providers in‑state (96th percentile; notably above typical state volume) and D1206 is #3 of 162 providers (99th percentile; notably above typical state volume) — indicating above‑typical statewide volume for sealants and fluoride. By contrast, the top revenue driver D2930, while accounting for 23.9% of Medicaid revenue ($1.6M), ranks #3 of 11 providers (80th percentile; typical, unremarkable volume), so its dominance of this practice’s revenue is not mirrored by overwhelming statewide share for that specific code.

Several higher‑paid procedure lines appear intermittently in the mix and indicate treatment of higher‑acuity cases: D9223 generated $444K with $463 avg paid/claim and D9222 contributed $162.2K at $166 avg paid/claim, showing the clinic bills some specialty or anesthesia‑adjacent services in addition to routine care. These higher‑avg‑paid codes make up a smaller share of revenue but can materially affect margins when they occur.

The provider’s Medicaid volume sits alongside many high statewide percentiles on common visit and imaging codes — for example D0120 (Periodic oral evaluation) ranks #6 of 176 (97th percentile; typical, unremarkable volume) and D0210 (complete radiographic series) ranks #4 of 41 (93th percentile; typical, unremarkable volume) — suggesting consistently strong patient throughput and utilization of standard exam/diagnostic services. This pattern supports a stable operational model with steady recall and diagnostic workflows.

DAKOTA DENTAL 4 KIDS has an NPI enumeration date of 2019-07-12 (~7 years ago), indicating it is an established, mid‑tenure provider in the state; the combination of several high‑percentile preventive codes and a diversified service mix suggests the clinic has quickly scaled Medicaid volume since enumeration rather than being a long‑standing low‑volume outpost.

Medicaid: Complete Services Breakdown

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

40 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2930	N/A	8,630	$190	$1.6M
D1351	Sealant - per tooth	19,540	$30	$664.4K
D9223	N/A	960	$460	$444K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	4,380	$100	$424.7K
D1120	Prophylaxis–child	8,410	$40	$369.9K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	12,290	$30	$319.4K
D3220	N/A	2,630	$120	$302K
D0120	Periodic oral evaluation - established patient	8,160	$40	$285.5K
D2150	Amalgam - two surfaces, primary or permanent	2,710	$110	$284.1K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	3,800	$60	$224K

Showing 1–10 of 40

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Dakota Dental 4 Kids — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

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

40 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	3	10	230	$180	$1.3M
D9420	N/A	4	10	640	$160	$317.3K
D3220	N/A	3	10	720	$100	$297.4K
D9223	N/A	4	10	840	$140	$186.3K
D9222	N/A	5	10	980	$120	$182.5K
D1510	N/A	3	10	890	$180	$161.4K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	4	40	260	$90	$151.5K
D1351	Sealant - per tooth	3	50	400	$30	$117.3K
D2391	Resin‑based composite – one surface, posterior	8	40	150	$80	$115.5K
D2140	Amalgam - one surface, primary or permanent	3	10	40	$80	$111.6K

Showing 1–10 of 40

Nearby Providers

Other providers in the same ZIP code as Dakota Dental 4 Kids, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Black Hills Works Inc	SD	Developmentally Disabled Services Day Training Agency	$0	$149.7M
Great Plains Tribal Chairmen's Health Board	SD	Pharmacy	$0	$36.4M
Black Hills Pediatric Dentistry	SD	Pediatric Dentistry	$0	$24.7M
Oglala Sioux Tribe	SD	Obstetrics & Gynecology Physician	$0	$5.2M
Rushmore Ambulatory Surgery Center	SD	Ambulatory Surgical Clinic/Center	$0	$4.6M
Stay Graceful Inc	SD	In Home Supportive Care Agency	$0	$3.4M
Children's Care Hospital And School	SD	Rehabilitation Clinic/Center	$0	$2.1M
Rushmore Dental Products, Inc.	SD	Durable Medical Equipment & Medical Supplies	$0	$1.7M
Black Hills Orthopedic & Spine Center, Inc.	SD	Multi-Specialty Clinic/Center	$0	$1.7M
Black Hills Caregiving, LLC	SD	Home Health Agency	$0	$1.1M

Dakota Dental 4 Kids — Billing Profile & Reimbursement Data

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Dakota Dental 4 Kids — 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