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

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

Vital Smiles Alabama PC (NPI 1134421746)

Field	Value
Entity Type	Organization
Organization	Vital Smiles Alabama PC
Address	2727 Pleasant Valley Rd
City	Mobile
State	AL
ZIP	36606
Taxonomy	Health Maintenance Organization
NPI Enumerated	December 2, 2010

Payer Source	Total Paid
Medicaid	$1.3M
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
D1120	Prophylaxis–child	7,800	$30	$202.8K
D0120	Periodic oral evaluation - established patient	10,850	$20	$184.5K
D1208	Topical application of fluoride - excluding varnish	12,600	$10	$176.4K
D2930	N/A	1,670	$90	$143.6K
D0330	N/A	2,690	$40	$113.1K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	3,380	$30	$111.6K
D2150	Amalgam - two surfaces, primary or permanent	1,980	$60	$109.1K
D0272	N/A	4,350	$20	$69.7K
D2140	Amalgam - one surface, primary or permanent	1,400	$50	$63K
D0274	N/A	2,130	$20	$44.6K

Showing 1–10 of 20

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

Vital Smiles Alabama PC — 0 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	44	120	1,240	$90	$233.9K
D3330	N/A	13	20	40	$460	$115K
D1120	Prophylaxis–child	77	520	810	$30	$104.3K
D0120	Periodic oral evaluation - established patient	72	620	810	$20	$77.2K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	92	190	490	$50	$76.2K
D3220	N/A	46	60	350	$70	$70.1K
D1351	Sealant - per tooth	109	180	710	$20	$63.3K
D0330	N/A	65	390	410	$40	$61.2K
D1208	Topical application of fluoride - excluding varnish	60	540	970	$10	$60.1K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	60	490	510	$30	$53.8K

Showing 1–10 of 20

Nearby Providers

Other providers in the same ZIP code as Vital Smiles Alabama PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mobile Bay Dental, LLC	AL	General Practice Dentistry	$0	$3.6M
Premier Health Management, Inc.	AL	Ophthalmology Physician	$0	$3M
Scott Freeman	AL	MOHS-Micrographic Surgery Physician	$2.9M	$0
Lifeguard Ambulance Service LLC	AL	Land Ambulance	$414.6K	$2.2M
Mark Douglas	AL	Ophthalmology Physician	$2.1M	$0
Henry Semple	AL	Ophthalmology Physician	$2M	$0
Rehab Medical, LLC	AL	Durable Medical Equipment & Medical Supplies	$0	$1.9M
Mobile Bay Vision, LLC	AL	Optometrist	$0	$1.8M
Surgicare Of Mobile Ltd	AL	Ambulatory Surgical Clinic/Center	$1.5M	$101.9K
Sleep Management, L.L.C.	AL	Oxygen Equipment & Supplies (DME)	$0	$1.5M

Vital Smiles Alabama PC — Billing Profile & Reimbursement Data

Sign up for Vital Smiles Alabama PC — Billing Profile & Reimbursement Data policy alerts

Vital Smiles Alabama PC — Billing Profile & Reimbursement Data

Sign up for Vital Smiles Alabama PC — 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