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

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

Candler Road Dental, PC (NPI 1205923802)

Field	Value
Entity Type	Organization
Organization	Candler Road Dental, PC
Address	1756 Candler Road
City	Decatur
State	GA
ZIP	30032
Taxonomy	General Practice Dentistry
NPI Enumerated	October 6, 2006

Payer Source	Total Paid
Medicaid	$123.7M
Medicare	$0

Key Findings

This profile is effectively single‑payer: the provider has no Medicare billing on file and reports $123.7M in lifetime Medicaid revenue, indicating operations are overwhelmingly dependent on Medicaid reimbursement rather than Medicare. That scale of Medicaid-only revenue implies the practice serves a large publicly insured patient base rather than a mixed Medicare/Medicaid practice model.

Revenue concentration is substantial: the precomputed top three Medicaid codes (D2930, D2392, D1120) together account for 34.4% of the provider's total Medicaid revenue. Individually those codes generated $15M (12.3%), $14.4M (11.8%), and $12.5M (10.3%) respectively, showing a heavy share of income comes from a small set of restorative and preventive procedure codes.

The code-level mix points to a high‑volume general dental practice with a major pediatric/preventive focus plus frequent restorative work. High claim counts and payments for D1120 (Prophylaxis–child: 403.6K claims, $31 avg paid/claim, $12.5M) alongside large volumes of sealants D1351 (237.4K claims, $7.8M) and topical fluoride D1208 (455.9K claims, $7.3M) indicate intensive preventive care for children, while large revenues for posterior composite codes like D2392 (148.8K claims, $14.4M) and D2391 (111.2K claims, $8.7M) show substantial restorative throughput.

The provider is a statewide outlier and dominant competitor across many Medicaid procedure lines: numerous high‑revenue codes (including D2930, D2392, D1120, D0120) rank #1 in‑state and are labeled “extreme outlier” or 100th percentile, positioning this entity far above typical state volume for those services. Such a consistent pattern of top rankings across preventive, diagnostic and restorative codes signals market leadership in Medicaid dental delivery in Georgia rather than a modest or niche operation.

Not all service lines are uniformly exceptional: for several higher‑complexity codes the provider is a high but not top outlier — for example D7240 ranks #2 of 9 providers (88th percentile; described as typical, unremarkable) and D7210 ranks #2 of 20 (95th percentile; typical, unremarkable). These placements suggest outstanding dominance in routine preventive and restorative services but more conventional participation in certain surgical or specialty procedures.

Claim volumes reflect extremely high throughput: multiple codes exceed six‑figure claim counts (e.g., D1208 455.9K claims, D1120 403.6K claims, D0120 384.9K claims), which supports the interpretation of very large patient volume and fast operational scale rather than sporadic episodic care. High claim counts combined with relatively low avg paid/claim for many pediatric preventive codes are consistent with a high-volume, efficiency‑oriented model serving Medicaid beneficiaries.

Several codes beyond the top three are also labeled as statistical outliers or notably above typical state volume, reinforcing the provider’s outsized share of specific Medicaid services. Examples include D2391, D1351, D0272, D0220 and D0210 — many of which are 100th percentile in‑state and flagged as “extreme outlier,” indicating concentrated expertise and market capture across a broad set of routine dental procedures.

The provider has long tenure in the NPI system, enumerated on 2006-10-06 (~20 years ago), which combined with large, sustained Medicaid revenue suggests an established practice infrastructure and enduring presence in the Georgia Medicaid dental market. This longevity, together with dominant code-level rankings, strengthens its profile as a major incumbent in Medicaid dental services rather than a recent entrant or small clinic.

Medicaid: Complete Services Breakdown

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

50 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2930	N/A	92,640	$160	$15M
D2392	Post 2 surface resin‑based composite	148,780	$100	$14.4M
D1120	Prophylaxis–child	403,600	$30	$12.5M
D0120	Periodic oral evaluation - established patient	384,900	$20	$8.9M
D2391	Resin‑based composite – one surface, posterior	111,210	$80	$8.7M
D1351	Sealant - per tooth	237,400	$30	$7.8M
D1208	Topical application of fluoride - excluding varnish	455,950	$20	$7.3M
D0274	N/A	184,350	$30	$6.1M
D0150	Comprehensive oral evaluation – new or established patient	166,870	$30	$5.7M
D0272	N/A	252,180	$20	$5.3M

Showing 1–10 of 50

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Georgia Distribution

Candler Road Dental, PC — 22 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

50 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D7240	N/A	2	10	580	$240	$1M
D2930	N/A	1	40	300	$170	$529.9K
D2934	N/A	1	10	330	$140	$291.4K
D2392	Post 2 surface resin‑based composite	1	80	270	$90	$262.3K
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…	2	20	220	$120	$236.9K
D7230	N/A	2	10	420	$190	$235.3K
D2391	Resin‑based composite – one surface, posterior	1	60	190	$80	$186.8K
D1351	Sealant - per tooth	1	70	580	$30	$176.7K
D3220	N/A	1	20	140	$90	$175.7K
D1120	Prophylaxis–child	1	140	620	$30	$173.7K

Showing 1–10 of 50

Related Providers

Other providers that share a Tax Identification Number (TIN) with Candler Road Dental, PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Candler Road Dental, PC	GA	General Practice Dentistry	$0	$932.8K

Nearby Providers

Other providers in the same ZIP code as Candler Road Dental, PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tactical Medical Transport LLC	GA	Land Ambulance	$517.6K	$0
Prathyusha Vadlamani	GA	General Practice Dentistry	$0	$280.3K
Newport Integrated Behavioral Healthcare, Inc	GA	Substance Abuse Rehabilitation Facility	$0	$192.2K
Yolanda Cunningham	GA	Clinical Social Worker	$16.3K	$0

Candler Road Dental, PC — Billing Profile & Reimbursement Data

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Candler Road Dental, PC — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References