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

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

Mark Nelson (NPI 1215997663)

Field	Value
Entity Type	Individual
Organization	Mark Nelson
Address	1551 Renaissance Towne Dr
City	Bountiful
State	UT
ZIP	84010
Taxonomy	Pediatric Dentistry
NPI Enumerated	March 27, 2006

Payer Source	Total Paid
Medicaid	$354.7K
Medicare	$0

Medicaid: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D0120	Periodic oral evaluation - established patient	3,160	$70	$230.3K
D0220	Intraoral - periapical first radiographic image	450	$70	$30.7K
D1120	Prophylaxis–child	2,890	$10	$28.9K
D0272	N/A	1,150	$20	$24.1K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	3,360	$10	$23.5K
D0274	N/A	130	$50	$6.4K
D2150	Amalgam - two surfaces, primary or permanent	120	$30	$3.7K
D2140	Amalgam - one surface, primary or permanent	30	$90	$2.6K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	90	$20	$1.6K
D0150	Comprehensive oral evaluation – new or established patient	40	$30	$1.3K

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Utah Distribution

Mark Nelson — 0 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. Utah median

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D0120	Periodic oral evaluation - established patient	78	470	460	$80	$149.8K
D1351	Sealant - per tooth	189	190	620	$30	$60.7K
D2150	Amalgam - two surfaces, primary or permanent	151	220	290	$60	$45K
D0220	Intraoral - periapical first radiographic image	222	440	470	$20	$32.8K
D0150	Comprehensive oral evaluation – new or established patient	284	420	110	$100	$30.8K
D1120	Prophylaxis–child	85	420	440	$20	$30.7K
D2140	Amalgam - one surface, primary or permanent	141	170	200	$50	$25.2K
D0272	N/A	109	310	550	$20	$24.7K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	75	430	460	$10	$13.8K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	148	280	100	$40	$12.7K

Showing 1–10 of 14

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Treagan White	UT	Pediatric Dentistry	$0	$614.1K

Nearby Providers

Other providers in the same ZIP code as Mark Nelson, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bcbu, Inc.	UT	Home Health Agency	$0	$10.2M
Vali Division Of Wasatch, Inc	UT	Community Based Hospice Care Agency	$0	$8.4M
Hospital Corporation Of Utah	UT	General Acute Care Hospital	$0	$6M
South Davis Metro Fire Service Area	UT	Land Ambulance	$317.9K	$3.3M
Ryan K Anderson D P M P C	UT	Foot & Ankle Surgery Podiatrist	$0	$3.5M
Rocky Mountain Personal Care LLC	UT	In Home Supportive Care Agency	$0	$3M
Providential Bba Operating LP	UT	Home Health Agency	$0	$1.7M
Tautai Barton Creek, LLC	UT	Assisted Living Facility	$0	$1.5M
Mg Bountiful Subtenant LLC	UT	Assisted Living Facility	$0	$1.3M
Neurobehavioral Center For Growth LLC	UT	Psychologist	$0	$1.2M

Mark Nelson — Billing Profile & Reimbursement Data

Sign up for Mark Nelson — Billing Profile & Reimbursement Data policy alerts

Mark Nelson — Billing Profile & Reimbursement Data

Sign up for Mark Nelson — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References