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

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

Rubicon Dental Associates PLLC (NPI 1215357397)

Field	Value
Entity Type	Organization
Organization	Rubicon Dental Associates PLLC
Address	14 Avanta Way Ste 1
City	Billings
State	MT
ZIP	59102
Taxonomy	General Practice Dentistry
NPI Enumerated	April 16, 2014

Payer Source	Total Paid
Medicaid	$7.2M
Medicare	$0

Key Findings

This provider is effectively single‑payer: there is no Medicare billing on file and all recorded federal program revenue is Medicaid, totaling $7.2M. The absence of Medicare claims indicates the practice’s revenue profile and contractual exposure are concentrated in the Medicaid program rather than split across both payers.

Revenue is highly concentrated in a small set of services: the precomputed top 3 Medicaid codes account for 36.7% of this provider's total Medicaid revenue. The top three contributors are D2392 ($1.2M, 16.3%), D1110 ($808.2K, 11.4%), and D0120 ($640.5K, 9.0%), so a relatively small code set drives more than one‑third of Medicaid receipts.

The code mix indicates a high‑volume general dentistry practice with a strong emphasis on preventive care and routine maintenance. Large claim volumes for D0120 (24.6K claims, $640.5K) and D1110 (15.8K claims, $808.2K) together with D1206 (24.7K claims, $517.9K) show recurring adult and child prophylaxis and topical fluoride are core service lines. The presence of D1120 (10.7K claims, $395.6K) confirms substantial pediatric preventive activity as well.

Restorative services are an important revenue stream alongside prevention: D2392 (Post 2 surface resin‑based composite) is the single largest Medicaid code by dollar value at $1.2M, and other restorative codes such as D2393 ($217K), D2391 ($196.3K) and D2740 ($241.9K) appear in the top 25. This mix (high preventive volume plus meaningful resin‑based composite and crown activity) is consistent with a general practice that manages both routine maintenance and moderate restorative casework in a Medicaid population.

Diagnostic imaging and focused problem evaluations are unusually large contributors to output and throughput. D0220 (14.4K claims, $244.9K) ranks #1 of 145 providers in‑state (100th percentile; extreme outlier) and D0230 (8.5K claims, $67.8K) ranks #3 of 68 providers (97th percentile; notably above typical state volume), indicating heavy use of intraoral radiography to support the clinic’s high patient volume and procedural mix. D0140 (9.8K claims, $331.7K) and D0150 (5.2K claims, $182.8K) further show a substantial share of problem‑focused and comprehensive evaluations.

Competitively, the provider is a major statewide player for several preventive and imaging codes. D1110 is ranked #1 of 270 providers in‑state (100th percentile; extreme outlier, far above typical state volume), D0220 is also ranked #1 (100th percentile; extreme outlier), and D0120 ranks #8 of 298 (98th percentile; extreme outlier), which together indicate dominant market share in routine exams, cleanings, and basic imaging among Montana Medicaid providers. At the same time, several restorative and specialty codes have only typical or unremarkable statewide volumes (for example, D2930 and D2393 are described as typical, unremarkable volume), suggesting leadership is focused on preventive and diagnostic services rather than across every restorative niche.

Not all high‑revenue codes reflect dominance; the provider’s performance is mixed by code. Codes such as D2930 ($608.2K; rank #8 of 23, 68th percentile) and D2740 ($241.9K; rank #5 of 30, 86th percentile) are characterized as typical or unremarkable in statewide comparison, whereas other items like D0274 (rank #3 of 206, 99th percentile) are notably above typical state volume. This pattern suggests the practice’s scale delivers outsized volumes in screening, prophylaxis, and basic imaging but more ordinary participation in some higher‑cost restorative procedures.

The provider has been active for an extended period, with an NPI enumerated on 2014-04-16 (~12 years ago), indicating an established presence in the market. Combined with the Medicaid concentration ($7.2M) and the extreme outlier ranks on several high‑frequency codes, this tenure supports the conclusion that the practice is a stable, high‑volume Medicaid provider whose contract and access role in the state network is significant for routine dental care and imaging services.

Medicaid: Complete Services Breakdown

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

39 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2392	Post 2 surface resin‑based composite	8,620	$140	$1.2M
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	15,850	$50	$808.2K
D0120	Periodic oral evaluation - established patient	24,630	$30	$640.5K
D2930	N/A	4,540	$130	$608.2K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	24,660	$20	$517.9K
D1120	Prophylaxis–child	10,690	$40	$395.6K
D0140	Limited oral evaluation – problem focused	9,760	$30	$331.7K
D0274	N/A	8,850	$30	$300.7K
D0220	Intraoral - periapical first radiographic image	14,400	$20	$244.9K
D2740	N/A	380	$640	$241.9K

Showing 1–10 of 39

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Rubicon Dental Associates PLLC — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

39 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	8	20	2,090	$120	$493.4K
D8670	N/A	30	30	4,310	$80	$432.6K
D2392	Post 2 surface resin‑based composite	6	130	310	$120	$173.4K
D9248	N/A	4	20	530	$140	$150.4K
D1310	N/A	19	50	520	$40	$119.6K
D1351	Sealant - per tooth	20	60	590	$30	$101.4K
D2740	N/A	5	30	60	$580	$92.8K
D1120	Prophylaxis–child	13	180	200	$30	$88.4K
D1330	N/A	19	60	340	$20	$65.6K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	14	80	290	$50	$59.8K

Showing 1–10 of 39

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Youth Dynamics, Inc.	MT	Mental Illness Community Based Residential Treatment Facility	$0	$65.4M
New Day, Inc.	MT	Mental Illness Community Based Residential Treatment Facility	$0	$27.7M
Youth Dynamics, Inc.	MT	Professional Counselor	$0	$24.6M
Resource, Support, & Development, Inc.	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$21.3M
Brittany Curl	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.5M
Rimrock Pediatric Dentistry	MT	Pediatric Dentistry	$0	$15.2M
Bridges Of Montana	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$12.7M
The Childrens Clinic Of Billings, PC	MT	Pediatrics Physician	$0	$10.9M
Community Option Resource Enterprises, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$9.8M
Ryan K. Larsen Dmd & Associates	MT	Dental Anesthesiology	$0	$8.3M

Rubicon Dental Associates PLLC — Billing Profile & Reimbursement Data

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Rubicon Dental Associates 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