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

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

Wayne Claiborne (NPI 1114096427)

Field	Value
Entity Type	Individual
Organization	Wayne Claiborne
Address	10552 W Garverdale Court
City	Boise
State	ID
ZIP	83704
Taxonomy	Dentist
NPI Enumerated	November 8, 2006

Payer Source	Total Paid
Medicaid	$500.2K
Medicare	$0

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	2,740	$70	$177.8K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	2,470	$70	$168.1K
D0210	Intraoral - complete series of radiographic images	740	$120	$88.1K
D0140	Limited oral evaluation – problem focused	2,380	$10	$28.6K
D2150	Amalgam - two surfaces, primary or permanent	260	$60	$14.4K
D4346	N/A	50	$190	$8.4K
D0150	Comprehensive oral evaluation – new or established patient	1,640	$1	$6.5K
D1120	Prophylaxis–child	30	$90	$2.5K
D2160	Amalgam - three surfaces, primary or permanent	10	$120	$1.5K
D0274	N/A	1,300	$1	$1.3K

Showing 1–10 of 20

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Wayne Claiborne — 1 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1013	Sign language or oral interpretive services, per 15 minutes	37	40	960	$70	$461.2K
D1120	Prophylaxis–child	198	250	180	$60	$143K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	34	320	310	$80	$80.8K
D0210	Intraoral - complete series of radiographic images	26	120	140	$120	$66K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	11	110	300	$30	$32.4K
D0150	Comprehensive oral evaluation – new or established patient	29	220	220	$30	$21.2K
D2150	Amalgam - two surfaces, primary or permanent	7	20	150	$50	$15.6K
D0140	Limited oral evaluation – problem focused	8	200	190	$20	$10.7K
D2140	Amalgam - one surface, primary or permanent	4	10	140	$40	$9.1K
D4346	N/A	4	10	40	$130	$8.5K

Showing 1–10 of 20

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Full Circle Health, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$53.3M
Community Connections, Inc	ID	Case Management Agency	$0	$30M
K A Health Services LLC	ID	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$13.9M
County Of Ada	ID	Land Ambulance	$2M	$11.4M
Developmental Concepts, Inc.	ID	Developmental Disabilities Clinic/Center	$0	$13.2M
Pathways Of Idaho, LLC	ID	Community/Behavioral Health Agency	$0	$12M
Havenwood Caregiver Services Of Idaho, LLC	ID	In Home Supportive Care Agency	$0	$10.7M
Living Independently Forever, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$9.8M
Community Partnerships Of Idaho, Inc.	ID	Developmental Disabilities Clinic/Center	$0	$7.6M
All Horizons Inc	ID	Mental Health Counselor	$0	$6.7M

Wayne Claiborne — Billing Profile & Reimbursement Data

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Wayne Claiborne — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References