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

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

Spark Dental Tn, PLLC (NPI 1154087120)

Field	Value
Entity Type	Organization
Organization	Spark Dental Tn, PLLC
Address	1540 Rock Springs Rd
City	Smyrna
State	TN
ZIP	37167
Taxonomy	Orthodontics and Dentofacial Orthopedics Dentistry
NPI Enumerated	November 13, 2021

Payer Source	Total Paid
Medicaid	$33.8M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused practice: Total Medicaid revenue is $33.8M and there is no Medicare billing on file, so SPARK DENTAL TN, PLLC operates with a single large public-payer footprint rather than a mixed Medicare/Medicaid payer mix. Analysts should treat Medicaid as the material revenue stream when evaluating utilization, contracting leverage, and population served.

Revenue concentration is notable: the precomputed top 3 Medicaid codes (D1120, D2930, D0120) account for 36.8% of this provider's total Medicaid revenue. Those three codes alone therefore drive more than a third of reported Medicaid receipts, signaling concentrated dependence on a small set of high-volume services.

The top-revenue codes indicate a high-volume pediatric/preventive and general restorative throughput: D1120 (144.1K claims, $32 avg paid/claim, $4.6M revenue), D0120 (145.6K claims, $24 avg paid/claim, $3.5M revenue), and D1206 (159.2K claims, $21 avg paid/claim, $3.3M revenue) are among the largest contributors. Together these prophylaxis, periodic evaluation, and topical fluoride codes point to large-scale delivery of preventive services (especially for children), while additional high-volume restorative and extraction codes (e.g., D2392, D7140) show integrated restorative and surgical case-mix.

Several individual code volumes and statewide ranks mark this provider as a dominant Medicaid operator in Tennessee: D1120 ranks #1 of 658 providers (100th percentile; extreme outlier) and D0120 ranks #1 of 723 providers (100th percentile; extreme outlier), while many other codes (for example D1206, D2392, D7140, D1110) also sit at the 100th percentile and rank #1 statewide. These rank/percentile patterns imply the provider is a major, high-volume participant in the state dental Medicaid market for multiple core services.

There are atypically large volumes across diagnostic imaging and procedure codes as well: D0210 (17.8K claims, $53 avg paid/claim, $945.7K revenue) ranks #2 of 248 providers (100th percentile; extreme outlier) and D0220 (47.8K claims, $12 avg paid/claim, $573.4K revenue) ranks #1 of 590 providers (100th percentile; extreme outlier). The combination of very high counts of radiographic claims alongside preventive and restorative codes suggests streamlined, high-throughput clinic workflows that produce large per-period imaging and procedure counts.

Several codes with no description in the supplied list still contribute materially and rank highly: D2930 (39K claims, $104 avg paid/claim, $4.1M revenue) ranks #2 of 163 providers (99th percentile; extreme outlier) and D9248 (19.6K claims, $77 avg paid/claim, $1.5M revenue) ranks #1 of 91 providers (100th percentile; extreme outlier). Even without on-sheet descriptions, these codes’ claim counts, average paid/claim, and revenue show they are meaningful revenue drivers and should be prioritized for review.

A broad pattern of statistical outliers is present across the code mix: many codes are labeled “extreme outlier” or “notably above typical” with top-state ranks (multiple #1s and 100th percentiles), indicating volumes that are far above typical state peers for these services. This concentration of extreme rankings across preventive, restorative, extraction, and imaging CPT/HCPCS codes signals that the provider is not only large in aggregate Medicaid revenue but unusually large on a per-code basis statewide.

Tenure is short-to-medium: NPI enumerated on 2021-11-13 (~5 years ago). Given the rapid accrual of $33.8M in Medicaid revenue and the extreme-volume rankings in many codes within roughly five years of enumeration, the practice has achieved high utilization and scale quickly, a relevant factor when assessing growth dynamics and local competitive impact.

Medicaid: Complete Services Breakdown

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

52 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1120	Prophylaxis–child	144,070	$30	$4.6M
D2930	N/A	39,000	$100	$4.1M
D0120	Periodic oral evaluation - established patient	145,610	$20	$3.5M
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	159,230	$20	$3.3M
D2392	Post 2 surface resin‑based composite	35,140	$70	$2.5M
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	33,150	$60	$1.8M
D8670	N/A	19,960	$80	$1.6M
D9248	N/A	19,640	$80	$1.5M
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	31,750	$40	$1.3M
D2391	Resin‑based composite – one surface, posterior	18,890	$60	$1.1M

Showing 1–10 of 52

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Spark Dental Tn, PLLC — 24 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

52 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	2	160	770	$110	$399.1K
D8670	N/A	3	90	2,120	$90	$358.9K
D7240	N/A	45	60	500	$230	$316.3K
D8080	N/A	21	40	40	$1,120	$184.1K
D3220	N/A	5	110	610	$80	$167.4K
D9223	N/A	52	80	710	$80	$143.8K
D1120	Prophylaxis–child	1	660	720	$30	$135.9K
D2390	N/A	6	10	160	$150	$126.1K
D9248	N/A	1	90	450	$80	$116.4K
D2392	Post 2 surface resin‑based composite	1	470	450	$70	$107K

Showing 1–10 of 52

Nearby Providers

Other providers in the same ZIP code as Spark Dental Tn, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hca Health Services Of Tennessee, Inc.	TN	General Acute Care Hospital	$0	$28.2M
Spero Health Of Tennessee, LLC	TN	Substance Use Disorder Rehabilitation Clinic/Center	$0	$23.4M
Grace Pediatrics PLLC	TN	Pediatrics Physician	$0	$12M
Feltz Therapy Services, LLC	TN	Rehabilitation Clinic/Center	$0	$11.1M
Children's Dentistry Of Smyrna	TN	Pediatric Dentistry	$0	$8.2M
Nurture Pediatrics, PLLC	TN	Pediatrics Physician	$0	$5M
Cumberland Pediatric Dentistry And Orthodontics Of Murfreesboro, PLLC	TN	Pediatric Dentistry	$0	$4.1M
Smyrna Pediatrics PLLC	TN	Pediatrics Physician	$0	$3.7M
Newberry Emergency Physicians PLLC	TN	Emergency Medicine Physician	$0	$3M
Tennessee Family Solutions, Inc	TN	Developmentally Disabled Services Day Training Agency	$0	$3M

Spark Dental Tn, PLLC — Billing Profile & Reimbursement Data

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Spark Dental Tn, PLLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References