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

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

A Perfect Smile (NPI 1114314747)

Field	Value
Entity Type	Organization
Organization	A Perfect Smile
Address	230 N Fairgrounds Rd
City	Price
State	UT
ZIP	84501
Taxonomy	Dental Clinic/Center
NPI Enumerated	April 21, 2015

Payer Source	Total Paid
Medicaid	$1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D0120	Periodic oral evaluation - established patient	3,020	$130	$401.3K
D0140	Limited oral evaluation – problem focused	1,750	$100	$167.7K
D0220	Intraoral - periapical first radiographic image	6,200	$20	$124.1K
D2150	Amalgam - two surfaces, primary or permanent	1,130	$60	$64.6K
D0150	Comprehensive oral evaluation – new or established patient	250	$170	$40.4K
D0274	N/A	3,800	$10	$34.2K
D0230	Intraoral - periapical each additional radiographic image	10,420	$1	$31.3K
D2740	N/A	50	$560	$28.8K
D0330	N/A	130	$180	$23.7K
D2392	Post 2 surface resin‑based composite	270	$80	$21.1K

Showing 1–10 of 27

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Utah Distribution

A Perfect Smile — 3 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. Utah median

27 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D0120	Periodic oral evaluation - established patient	81	470	460	$80	$149.8K
D2740	N/A	11	20	60	$490	$110.3K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	31	40	260	$80	$66.8K
D1351	Sealant - per tooth	90	190	620	$30	$60.7K
D0140	Limited oral evaluation – problem focused	14	260	140	$120	$55.8K
D2150	Amalgam - two surfaces, primary or permanent	46	220	290	$60	$45K
D2392	Post 2 surface resin‑based composite	69	170	170	$80	$39.4K
D0220	Intraoral - periapical first radiographic image	17	440	470	$20	$32.8K
D0150	Comprehensive oral evaluation – new or established patient	139	420	110	$100	$30.8K
D1120	Prophylaxis–child	117	420	440	$20	$30.7K

Showing 1–10 of 27

Nearby Providers

Other providers in the same ZIP code as A Perfect Smile, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Four Corners Community Behavioral Health, Inc.	UT	Community/Behavioral Health Agency	$0	$19.5M
Castleview Hospital LLC	UT	Rural Acute Care Hospital	$0	$6M
Four Corners Community Behavioral Health, Inc.	UT	Community/Behavioral Health Agency	$0	$2.8M
Shane D Gagon Md, PC	UT	Family Medicine Physician	$0	$2.5M
County Of Carbon	UT	Land Ambulance	$322.9K	$1.8M
Four Corners Community Behavioral Health Inc	UT	Methadone Clinic	$0	$817.1K
West Emergency Services, LLC	UT	Emergency Medicine Physician	$0	$810.3K
Southeastern Utah District Health Department	UT	Public Health or Welfare Agency	$28.8K	$666.5K
Castleview Physician Practice, LLC	UT	Family Medicine Physician	$0	$653.9K
Carbon School District	UT	Local Education Agency (LEA)	$0	$622.5K

A Perfect Smile — Billing Profile & Reimbursement Data

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A Perfect Smile — Billing Profile & Reimbursement Data

Sign up for A Perfect Smile — 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