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

Why is the Medicaid comparison limited to Oklahoma 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. Oklahoma (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 Dental Partners PLLC (NPI 1093062911)

Field	Value
Entity Type	Organization
Organization	Pediatric Dental Partners PLLC
Address	5940 Nw Expressway Ste 200
City	Oklahoma City
State	OK
ZIP	73132
Taxonomy	Pediatric Dentistry
NPI Enumerated	August 9, 2012

Payer Source	Total Paid
Medicaid	$39.4M
Medicare	$0

Key Findings

This practice is effectively a Medicaid-only billing entity: Total Medicare revenue is none (no Medicare billing on file) while total Medicaid revenue is $39.4M, indicating the provider’s commercial footprint in CMS fee-for-service is absent and its scale is concentrated in state Medicaid programs. Analysts should treat this as a single-payer Medicaid profile when assessing payer exposure and network value.

Revenue is highly concentrated in a very small set of procedures: the precomputed top 3 Medicaid codes by revenue account for 49.0% of this provider's total Medicaid revenue, driven by D2930 ($13.6M, 35.0%), D3220 ($2.7M, 7.1%), and D2392 ($2.7M, 6.9%). That concentration means a large share of dollars flow from a few procedure types, which heightens sensitivity to reimbursement or utilization changes for those codes.

The code mix and volumes denote a high-volume pediatric restorative and preventive dental operation. High-volume restorative codes such as D2392 (27.1K claims, $2.7M) appear alongside major preventive codes—D1120 (78.5K claims, $2.4M), D1206 (84.5K claims, $1.4M), and D1351 (40.8K claims, $937.6K)—consistent with a practice focused on routine child dental care plus significant restorative throughput. These claim counts suggest substantial pediatric patient throughput rather than a low-volume specialty referral center.

Competitive standing in-state is dominant across many codes: the provider ranks #1 for D2930 (of 93 providers), D3220 (of 61), D2392 (of 330) and numerous other codes, with many listed as 100th percentile and labeled as extreme outlier or notably above typical state volume. This pattern indicates market leadership in Oklahoma City for pediatric dental services under Medicaid and positions the provider as a major in-state capacity source for the listed procedures.

The practice delivers both preventive and higher-acuity procedural care in volume: extractions and operative services are prominent (D7140: 40.3K claims, $2.6M) alongside diagnostic imaging (D0220: 27K claims, $405.3K; D0272: 44.3K claims, $797.7K) and restorative codes (D2392, D2391, D2330). The coexistence of high counts of prophylaxis, sealants, restorations, extractions, and radiographs suggests an end-to-end pediatric dental workflow including preventive visits, operative treatment, and imaging within the same network of sites.

Multiple codes show unusually high state-level volume beyond what peers report, and several are explicitly characterized as extreme outlier volumes; for example D2930 and D2392 are flagged as extreme outliers and the provider ranks at the 100th percentile. This breadth of outlier classifications across preventive, restorative, and diagnostic codes implies the provider’s scale is atypical for Oklahoma and may represent centralized or multi-location operations capturing a large share of pediatric Medicaid visits.

Operational longevity supports the observed scale: the NPI was enumerated on 2012-08-09 (~14 years ago), indicating an established presence in the market. Sustained enumeration combined with the current high Medicaid revenue ($39.4M) and repeated top-state rankings suggest the provider has grown and maintained extensive service volume over multiple years.

For risk and contracting considerations, the combination of very high per-code volumes (e.g., D1206 84.5K claims; D1120 78.5K claims) and reliance on a few revenue-driving codes (top 3 = 49.0% of Medicaid revenue) means any policy changes to reimbursement or utilization management for these key pediatric dental codes could materially affect this provider’s revenue stream. Payers should treat negotiations or utilization controls on these codes as high-impact levers for this provider relationship.

Medicaid: Complete Services Breakdown

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

38 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2930	N/A	115,930	$120	$13.6M
D3220	N/A	31,190	$90	$2.7M
D2392	Post 2 surface resin‑based composite	27,120	$100	$2.7M
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	40,270	$60	$2.6M
D1120	Prophylaxis–child	78,540	$30	$2.4M
D3230	N/A	24,060	$100	$2.3M
D9248	N/A	11,710	$130	$1.5M
D0120	Periodic oral evaluation - established patient	72,040	$20	$1.5M
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	84,480	$20	$1.4M
D1351	Sealant - per tooth	40,770	$20	$937.6K

Showing 1–10 of 38

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oklahoma Distribution

Pediatric Dental Partners PLLC — 24 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oklahoma

Full comparison — all codes billed, vs. Oklahoma median

38 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D3230	N/A	1	10	1,150	$100	$577.4K
D2930	N/A	1	90	1,120	$120	$530.4K
D2932	N/A	1	10	2,680	$140	$418.1K
D9248	N/A	1	40	640	$130	$218.1K
D3220	N/A	1	60	560	$90	$191.9K
D2392	Post 2 surface resin‑based composite	1	330	530	$100	$162.1K
D2393	Resin-based composite, three surfaces, posterior	55	190	300	$140	$128.6K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	1	240	280	$70	$91.8K
D1517	N/A	1	10	450	$180	$81.2K
D1120	Prophylaxis–child	1	470	730	$30	$77.5K

Showing 1–10 of 38

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Healthcare Innovations Private Services	OK	Home Health Agency	$0	$49.1M
Quick Test Lab Diagnostics LLC	OK	Clinical Medical Laboratory	$3.8M	$248.5K
Red Dirt Orthodontics PLLC	OK	Dental Clinic/Center	$0	$3.9M
Express Family Care LLC	OK	Primary Care Clinic/Center	$0	$2M
Miracles Counseling Services, LLC	OK	Community/Behavioral Health Agency	$0	$1.7M
Perigon Imaging LLC	OK	Radiology Clinic/Center	$478.8K	$0
Travis Gittins	OK	Optometrist	$35.4K	$294.2K
Sams East Inc	OK	Community/Retail Pharmacy	$100.5K	$0
Jerry Mullen	OK	Optometrist	$20.3K	$0
Jenny Mikes	OK	Registered Dietitian	$2.4K	$0

Pediatric Dental Partners PLLC — Billing Profile & Reimbursement Data

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Pediatric Dental Partners PLLC — 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