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

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

Dr. Clyde A. Maxwell Jr, PA (NPI 1053464560)

Field	Value
Entity Type	Organization
Organization	Dr. Clyde A. Maxwell Jr, PA
Address	303 E Lea Blvd
City	Wilmington
State	DE
ZIP	19802
Taxonomy	Dental Clinic/Center
NPI Enumerated	January 19, 2007

Payer Source	Total Paid
Medicaid	$10.2M
Medicare	$0

Key Findings

DR. CLYDE A. MAXWELL JR, PA is effectively a Medicaid-focused dental clinic: total Medicaid revenue on file is $10.2M and there is no Medicare billing on file, so the provider operates as a near‑single‑payer Medicaid participant. The NPI was enumerated 2007-01-19 (~19 years ago), indicating long-tenure in the state market that supports sustained Medicaid activity.

Revenue is concentrated in a small set of restorative and preventive codes: the top three Medicaid codes by revenue account for 36.5% of the provider’s total Medicaid revenue. The largest individual contributors are D2392 ($1.7M, 16.8%), D1351 ($1.1M, 10.4%), and D1120 ($936.8K, 9.2%), highlighting a mix of posterior composite restorations and high-volume preventive pediatric care as primary revenue drivers.

The code mix points to a high-volume pediatric and general-dentistry service line: D1351 (sealant), D1120 (prophylaxis–child), and D1206 (topical fluoride) are all among the top codes, while D2392/D2393/D2391 indicate extensive posterior resin‑based restorative work. This combination suggests clinic operations oriented around routine preventive visits for children plus on-site restorative capacity rather than specialty services.

This provider is an outsized statewide performer on intraoral radiographs: D0230 (30.4K claims, $608.4K revenue) ranks #2 of 88 providers in-state at the 99th percentile and is described as an "extreme outlier, far above typical state volume for this code." D0220 likewise ranks #3 of 113 providers at the 98th percentile, reinforcing that diagnostic imaging volume is materially higher here than for most peers.

Preventive services also show above‑typical statewide volume: D1351 ranks #4 of 67 providers (95th percentile) and D1120 ranks #5 of 116 providers (97th percentile), while D1206 sits at the 96th percentile. These rankings indicate the provider is a major delivery point for Medicaid pediatric preventive care in Delaware rather than a marginal participant.

Restorative composite procedures produce substantial revenue beyond preventive work: D2392 ($1.7M, 16.8%) is the single largest revenue code, with D2393 ($593K) and D2391 ($579.4K) also contributing meaningfully. The presence of several mid‑to‑high average paid restorative codes (e.g., $191 avg for D2392, $237 avg for D2393) alongside high claims volumes shows a balanced reliance on both procedure count and higher unit-value services.

Operational throughput is reflected in a dual pattern of very high claim volumes for low‑unit‑price diagnostics/preventive codes (e.g., 30.4K claims for D0230 at $20 avg, 22.6K claims for D1351 at $47 avg) and lower-count, higher‑unit‑price restorative codes. For payers and network managers, this suggests capacity is focused on frequent preventive/diagnostic visits with substantial on-site restorative follow-up, which affects scheduling, utilization monitoring, and reimbursement planning.

From a risk and contract perspective, the provider’s heavy concentration in Medicaid and the fact that the top three codes account for 36.5% of Medicaid revenue mean payer exposure is concentrated: changes to reimbursement, eligibility, or utilization management policies for these high-volume codes could materially alter the provider’s Medicaid revenue. Given the "extreme outlier" and multiple high‑percentile flags on specific codes, payers may want to prioritize utilization review and comparative benchmarking for D0230, D0220, and the top preventive codes.

Medicaid: Complete Services Breakdown

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

33 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2392	Post 2 surface resin‑based composite	8,970	$190	$1.7M
D1351	Sealant - per tooth	22,580	$50	$1.1M
D1120	Prophylaxis–child	17,350	$50	$936.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	21,630	$30	$713.9K
D0230	Intraoral - periapical each additional radiographic image	30,420	$20	$608.4K
D2393	Resin-based composite, three surfaces, posterior	2,500	$240	$593K
D2391	Resin‑based composite – one surface, posterior	3,810	$150	$579.4K
D0120	Periodic oral evaluation - established patient	14,460	$40	$578.4K
D0220	Intraoral - periapical first radiographic image	19,460	$20	$467.1K
D0272	N/A	11,030	$40	$396.9K

Showing 1–10 of 33

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Dr. Clyde A. Maxwell Jr, PA — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

33 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D8670	N/A	18	20	2,720	$230	$1.2M
D8090	N/A	11	10	200	$1,910	$774.6K
D2930	N/A	12	30	580	$260	$446.8K
D8660	N/A	8	10	810	$330	$422.7K
D2392	Post 2 surface resin‑based composite	3	90	490	$220	$366.3K
D2393	Resin-based composite, three surfaces, posterior	5	40	260	$270	$226.1K
D1351	Sealant - per tooth	4	70	1,690	$40	$217.1K
D2391	Resin‑based composite – one surface, posterior	6	70	320	$180	$192K
D1120	Prophylaxis–child	5	120	960	$50	$163.3K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	17	60	270	$140	$137K

Showing 1–10 of 33

Nearby Providers

Other providers in the same ZIP code as Dr. Clyde A. Maxwell Jr, PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mid-atlantic Dental Partners Delaware Ii Professional Associates	DE	General Practice Dentistry	$0	$21.8M
Greater Works Companion Care	DE	Home Health Agency	$0	$10.8M
Opportunity Center Inc	DE	Intellectual & Developmental Disabilities Psychologist	$0	$3M
The Life Center Complex, Inc	DE	Community Health Clinic/Center	$0	$1.9M
Francis Mase M.d., P.A.	DE	Pediatrics Physician	$0	$1.8M
Precision Care & Wellness, LLC	DE	Primary Care Clinic/Center	$0	$1.8M
Bio-medical Applications Of Delaware, Inc.	DE	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.1M
Bio-medical Applications Of Delaware, Inc.	DE	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$487.1K
Connections Csp Brandywine Street Women's Residential Treatment Progra	DE	Substance Use Disorder Rehabilitation Clinic/Center	$0	$463.3K
Christiana Care Health Services Inc	DE	Student Health Clinic/Center	$0	$167.6K

Dr. Clyde A. Maxwell Jr, PA — Billing Profile & Reimbursement Data

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Dr. Clyde A. Maxwell Jr, PA — 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