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

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

Gentle Care Dental Associates PC (NPI 1144415183)

Field	Value
Entity Type	Organization
Organization	Gentle Care Dental Associates PC
Address	278 South Marine Corp Drive
City	Tamuning
State	GU
ZIP	96931
Taxonomy	Dentist
NPI Enumerated	September 12, 2007

Payer Source	Total Paid
Medicaid	$3M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $3M in lifetime Medicaid revenue, making its commercial exposure effectively absent in the Medicare dataset and its operations heavily Medicaid-focused. Analysts should treat GENTLE CARE DENTAL ASSOCIATES PC as a single-payer (Medicaid) billing entity for strategic and comparative work.

Revenue concentration is high: the precomputed top-three Medicaid codes account for 52.6% of the provider's total Medicaid revenue, with a single code, D2940, contributing $1.2M (39.0% of Medicaid revenue). This indicates material reliance on that code for overall practice revenue and elevates the importance of understanding what services D2940 represents in the local market.

The code mix indicates a general dental practice with a strong mix of preventive and restorative services. High volumes of preventive/evaluation and imaging codes—D1120 with 3.3K claims ($189.3K revenue), D0220 with 3.4K claims ($50.4K revenue), D0230 with 2.7K claims ($98.6K revenue), and D0150 with 2.8K claims ($207.8K revenue)—combined with restorative codes such as D2150 (1.4K claims, $204.1K) imply routine pediatric and adult preventive throughput alongside restorative casework.

Although D2940 dominates revenue, the provider is not a statewide monopolist for that service: D2940 ranks #2 of 5 in-state at the 75th percentile, so the practice is a strong but not dominant regional performer on its top revenue driver. Similarly, D0150 ranks #3 of 10 (78th percentile) and D2150 ranks #4 of 8 (57th percentile), which positions the provider as a consistent, typical-volume participant rather than an outlier leader across most commonly billed codes.

Average paid-per-claim patterns show a split between low-reimbursement high-volume services and fewer high-reimbursement procedures. For example, imaging and routine evaluations have low average paid-per-claim (D0220 $15, D0230 $36, D0120 $25) but high claim counts, while a small set of codes carry high averages (D2940 $570, D4220 $415, D2930 $353), indicating the practice combines high patient throughput for preventive/diagnostic care with episodic higher-intensity restorative or surgical procedures.

Several codes associated with pediatric care and preventive services show particularly high state-level volume percentiles, underscoring a measurable pediatric/preventive focus: D1120 ranks #3 of 11 providers in-state at the 80th percentile and D1203 ranks #3 of 11 at the 80th percentile. This pattern suggests the provider draws a substantial number of Medicaid-covered children for routine prophylaxis and related low-intensity services.

The provider has an established presence: the NPI was enumerated on 2007-09-12 (~19 years ago), which supports interpreting observed patterns as the result of a longstanding practice rather than a short-term billing fluctuation. This tenure strengthens the confidence that the code mix and volumes reflect an ongoing service model rather than a transient reporting artifact.

Medicaid: Complete Services Breakdown

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2940	N/A	2,080	$570	$1.2M
D0150	Comprehensive oral evaluation – new or established patient	2,810	$70	$207.8K
D2150	Amalgam - two surfaces, primary or permanent	1,440	$140	$204.1K
D2930	N/A	570	$350	$202.6K
D1120	Prophylaxis–child	3,260	$60	$189.3K
D4220	N/A	450	$420	$186.8K
D0230	Intraoral - periapical each additional radiographic image	2,740	$40	$98.6K
D9230	N/A	2,180	$40	$87.2K
D3220	N/A	420	$210	$86.9K
D3120	N/A	870	$100	$84.3K

Showing 1–10 of 26

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Guam Distribution

Gentle Care Dental Associates PC — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Guam

Full comparison — all codes billed, vs. Guam median

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D4220	N/A	5	10	940	$200	$845.2K
D2930	N/A	4	10	570	$180	$587.4K
D3220	N/A	4	10	560	$110	$406.3K
D2940	N/A	2	10	1,230	$220	$377.8K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	5	10	490	$160	$322.3K
D2150	Amalgam - two surfaces, primary or permanent	4	10	1,360	$100	$315.6K
D1120	Prophylaxis–child	3	10	2,140	$60	$195.3K
D0150	Comprehensive oral evaluation – new or established patient	3	10	1,460	$70	$192.7K
D2160	Amalgam - three surfaces, primary or permanent	4	10	530	$110	$139.3K
D3120	N/A	3	10	850	$40	$136.9K

Showing 1–10 of 26

Gentle Care Dental Associates PC — Billing Profile & Reimbursement Data

Sign up for Gentle Care Dental Associates PC — Billing Profile & Reimbursement Data policy alerts

Gentle Care Dental Associates PC — Billing Profile & Reimbursement Data

Sign up for Gentle Care Dental Associates PC — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Frequently Asked Questions

References