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

Why is the Medicaid comparison limited to North Dakota 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. North Dakota (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.

Stanley B. Hirst Dds PC (NPI 1134429053)

Field	Value
Entity Type	Organization
Organization	Stanley B. Hirst Dds PC
Address	1839 S. Broadway
City	Minot
State	ND
ZIP	58701
Taxonomy	General Practice Dentistry
NPI Enumerated	October 26, 2010

Payer Source	Total Paid
Medicaid	$13.3K
Medicare	$0

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1208	Topical application of fluoride - excluding varnish	200	$20	$4.1K
D0120	Periodic oral evaluation - established patient	150	$20	$3.6K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	70	$50	$3.5K
D0274	N/A	60	$30	$1.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	20	$20	$320
D1999	N/A	50	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Dakota Distribution

Stanley B. Hirst Dds PC — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Dakota

Full comparison — all codes billed, vs. North Dakota median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D0120	Periodic oral evaluation - established patient	71	120	350	$40	$46.8K
D1208	Topical application of fluoride - excluding varnish	20	30	320	$20	$26.3K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	51	80	160	$40	$24.1K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	103	110	230	$20	$23.6K
D0274	N/A	42	50	240	$30	$14.3K
D1999	N/A	10	20	50	$0	$0

Stanley B. Hirst Dds PC — Billing Profile & Reimbursement Data

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Stanley B. Hirst Dds PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Frequently Asked Questions

References