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

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

Capital Dental, LLC (NPI 1194372581)

Field	Value
Entity Type	Organization
Organization	Capital Dental, LLC
Address	5609 S 27th St Ste D
City	Lincoln
State	NE
ZIP	68512
Taxonomy	Dentist
NPI Enumerated	August 21, 2019

Payer Source	Total Paid
Medicaid	$4.5M
Medicare	$0

Key Findings

This provider is effectively single‑payer in the claims data: there is no Medicare billing on file and total Medicaid revenue is $4.5M, with an NPI enumerated on 2019-08-21 (~7 years ago), indicating a multi‑year presence in the registry but Medicaid as the clear revenue source.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes by revenue account for 74.9% of this provider's total Medicaid revenue. The three top codes are D7240 ($2M, 45.9%), D7210 ($750.8K, 16.8%), and D7140 ($547.5K, 12.3%), showing a dependence on a small set of highly paid procedural codes.

The code mix indicates a procedure‑focused dental operation dominated by extractions and related surgical removals: D7210 (extraction with sectioning and bone removal) and D7140 (simple extraction) together represent substantial share and volume, while D0140 (Limited oral evaluation – problem focused) appears as a high‑volume diagnostic entry point (5.2K claims). This pattern is consistent with a practice handling large numbers of acute/problem evaluations that progress to procedural extractions.

Competitive standing in-state is strong for the top procedures: D7240 ranks #1 of 13 providers in-state (100th percentile; notably above typical state volume for this code), D7210 ranks #3 of 28 (93th percentile; notably above typical state volume), and D7140 ranks #4 of 95 (97th percentile; notably above typical state volume). These percentiles indicate the provider is a dominant or major participant for several of the extraction-related codes within Nebraska.

Volume and throughput are substantial across multiple codes: D7240 has 6.1K claims, D7210 and D7140 each have 5.3K claims, D9243 has 9.5K claims ($504.1K, 11.3% of Medicaid revenue), and D0140 has 5.2K claims. The combination of high claim counts and material revenue shares suggests operational capacity for high procedural turnover rather than a low‑volume specialty.

Several codes show notable statistical standing versus peers: D0140 is flagged as an extreme outlier (ranks #3 of 159; 99th percentile), and D7240/D7210/D7140 are described as notably above typical state volume. By contrast, D9243—while ranking #1 of 4 providers (100th percentile)—is described as typical, unremarkable volume, highlighting that rank alone does not always imply an exceptional deviation from state norms.

There are administrative or non‑paying line items in the ledger: D9995 (135 claims) and D9996 (19 claims) both report $0 avg paid/claim and $0 revenue. These entries suggest billed activity that did not generate Medicaid payments and should be reviewed as part of any operational or coding audit to understand the reason for zero paid amounts.

The concentration of $4.5M of Medicaid revenue in a few extraction and problem‑visit codes implies business risk if Medicaid reimbursement or coverage policies change for those services, and it indicates limited payer diversification given the absence of Medicare activity; analysts should treat payer mix and top‑code exposure as primary factors shaping this provider's financial sensitivity.

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D7240	N/A	6,060	$340	$2M
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	5,330	$140	$750.8K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	5,260	$100	$547.5K
D9243	N/A	9,510	$50	$504.1K
D7230	N/A	790	$280	$222K
D9239	N/A	3,300	$60	$194.7K
D0140	Limited oral evaluation – problem focused	5,180	$20	$124.2K
D7220	N/A	120	$200	$24.5K
D0330	N/A	520	$40	$21.4K
D7250	N/A	100	$160	$15.2K

Showing 1–10 of 15

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Capital Dental, LLC — 4 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D7240	N/A	1	10	530	$250	$429.6K
D9243	N/A	1	10	5,090	$60	$304.9K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	3	30	380	$100	$145.8K
D9239	N/A	2	10	1,460	$60	$118.7K
D7230	N/A	4	10	110	$200	$92.2K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	4	100	180	$60	$58.2K
D7220	N/A	4	10	280	$140	$39.9K
D9230	N/A	69	90	260	$30	$32.2K
D1999	N/A	234	270	450	$10	$17.9K
D0140	Limited oral evaluation – problem focused	3	160	200	$20	$14.5K

Showing 1–10 of 15

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Community Supports Network Inc	NE	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$51.6M
Laboratory Corporation Of America Holdings	NE	Clinical Medical Laboratory	$128.8K	$2.9M
Schmidt Speech Language Pathology Services LLC	NE	Speech-Language Pathologist	$0	$1.1M
Daring Minds Therapy LLC	NE	Mental Health Counselor	$0	$1.1M
Ahp-mhr Home Care, LLP	NE	Oxygen Equipment & Supplies (DME)	$0	$1M
Logan Helge	NE	Family Nurse Practitioner	$996.6K	$0
Geoffrey Basler	NE	Dermatology Physician	$711K	$0
Geoffrey C. Basler, M.d. P.C.	NE	Dermatology Physician	$0	$449.6K
Horak Chiropractic & Acupuncture LLC	NE	Chiropractor	$0	$325.5K
Rex Largen	NE	Dermatology Physician	$288.5K	$0

Capital Dental, LLC — Billing Profile & Reimbursement Data

Sign up for Capital Dental, LLC — Billing Profile & Reimbursement Data policy alerts

Capital Dental, LLC — Billing Profile & Reimbursement Data

Sign up for Capital Dental, LLC — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References