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

Why is the Medicaid comparison limited to South 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. South 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.

Madison Family Dental Prof LLC (NPI 1184279036)

Field	Value
Entity Type	Organization
Organization	Madison Family Dental Prof LLC
Address	502 Ne 2nd St
City	Madison
State	SD
ZIP	57042
Taxonomy	General Practice Dentistry
NPI Enumerated	August 7, 2019

Payer Source	Total Paid
Medicaid	$51.8K
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
D0120	Periodic oral evaluation - established patient	780	$30	$24.2K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	620	$20	$14.8K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	140	$50	$7.5K
D1120	Prophylaxis–child	110	$40	$4.2K
D0150	Comprehensive oral evaluation – new or established patient	10	$50	$590
D0274	N/A	10	$40	$520

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Madison Family Dental Prof LLC — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

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

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D1120	Prophylaxis–child	86	140	150	$40	$59.7K
D0120	Periodic oral evaluation - established patient	54	180	320	$30	$50.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	57	160	270	$30	$50.1K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	85	140	200	$60	$41.2K
D0150	Comprehensive oral evaluation – new or established patient	99	110	100	$60	$30.9K
D0274	N/A	94	110	120	$40	$18.9K

Nearby Providers

Other providers in the same ZIP code as Madison Family Dental Prof LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Every Citizen Counts Organization	SD	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$20.7M
Madison Community Hospital	SD	Critical Access Hospital	$0	$1M
Eyecare Center Of Madison Prof LLC	SD	Optometrist	$0	$244.1K
Inter-lakes Community Action Partnership	SD	Voluntary or Charitable Agency	$0	$192.5K
Sanford Medical Center	SD	Community/Retail Pharmacy	$119.8K	$290
Madison Central School District	SD	Local Education Agency (LEA)	$0	$87K
Kevin M. Donlin, D.m.d., P.C.	SD	General Practice Dentistry	$0	$82K
Jason Evans	SD	Neurology Chiropractor	$60.8K	$0
Ben Liscano	SD	Family Medicine Physician	$42.7K	$0
Avera Home Medical Equipment, LLC	SD	Durable Medical Equipment & Medical Supplies	$0	$41.4K

Madison Family Dental Prof LLC — Billing Profile & Reimbursement Data

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Madison Family Dental Prof LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References