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

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

Kool Smiles, Psc (NPI 1205026788)

Field	Value
Entity Type	Organization
Organization	Kool Smiles, Psc
Address	1301 Winchester Rd
City	Lexington
State	KY
ZIP	40505
Taxonomy	General Practice Dentistry
NPI Enumerated	July 31, 2007

Payer Source	Total Paid
Medicaid	$30.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

51 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1120	Prophylaxis–child	97,380	$50	$4.7M
D8080	N/A	1,760	$1,870	$3.3M
D0120	Periodic oral evaluation - established patient	81,890	$20	$1.6M
D2392	Post 2 surface resin‑based composite	25,020	$70	$1.6M
D1208	Topical application of fluoride - excluding varnish	105,910	$20	$1.6M
D2930	N/A	14,580	$110	$1.6M
D0330	N/A	36,770	$40	$1.4M
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	29,150	$50	$1.4M
D1351	Sealant - per tooth	73,360	$20	$1.4M
D0150	Comprehensive oral evaluation – new or established patient	48,290	$30	$1.3M

Showing 1–10 of 51

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Kool Smiles, Psc — 21 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D8080	N/A	4	60	140	$1,840	$742.6K
D7240	N/A	6	70	620	$210	$354.3K
D8670	N/A	6	60	180	$610	$332K
D2930	N/A	3	160	610	$110	$228.6K
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…	34	230	350	$100	$162.2K
D1120	Prophylaxis–child	2	770	500	$50	$127.1K
D7230	N/A	9	40	200	$170	$93.8K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	9	520	560	$50	$85.2K
D2392	Post 2 surface resin‑based composite	2	630	420	$60	$74.5K
D0150	Comprehensive oral evaluation – new or established patient	3	1,010	740	$30	$61.4K

Showing 1–10 of 51

Related Providers

Other providers that share a Tax Identification Number (TIN) with Kool Smiles, Psc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Homrighausen	IN	Oral and Maxillofacial Surgery (Dentist)	$0	$3.3M

Nearby Providers

Other providers in the same ZIP code as Kool Smiles, Psc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
2nd Chance	KY	Addiction Medicine (Internal Medicine) Physician	$0	$25.1M
Kvc Behavioral Healthcare Kentucky Inc	KY	Mental Health Counselor	$0	$11.1M
Optimal Living Services, LLC	KY	Substance Abuse Rehabilitation Facility	$0	$10.4M
Perfect Imperfections Ky, LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$0	$7.7M
Ljks	KY	Professional Counselor	$0	$5.1M
Vitality Dx LLC	KY	Clinical Medical Laboratory	$34.4K	$2.1M
Jonathan Cole	KY	Clinical Psychologist	$111.7K	$0
Amanda Merchant	KY	Clinical Psychologist	$74.4K	$0
James Angel	KY	Urology Physician	$61K	$0
Abram Keating	KY	Family Nurse Practitioner	$32.8K	$0

Kool Smiles, Psc — Billing Profile & Reimbursement Data

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Kool Smiles, Psc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References