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

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

Ahl And O'connor Orthodontics, LLC (NPI 1235594268)

Field	Value
Entity Type	Organization
Organization	Ahl And O'connor Orthodontics, LLC
Address	1004 S State St
City	Dover
State	DE
ZIP	19901
Taxonomy	Orthodontics and Dentofacial Orthopedics Dentistry
NPI Enumerated	December 17, 2015

Payer Source	Total Paid
Medicaid	$12.5M
Medicare	$0

Key Findings

This provider operates effectively as a Medicaid-focused specialty practice: there is no Medicare billing on file and the entire reported lifetime revenue is $12.5M of Medicaid activity. The absence of Medicare billing indicates the provider’s payer mix is functionally single-payer (Medicaid) in scale and exposure rather than a dual Medicare/Medicaid profile.

Revenue is highly concentrated in a very small set of procedure codes: the top three Medicaid codes (D8670, D8020, D8090) together account for 87.5% of this provider's total Medicaid revenue. Individually these codes represent $4.6M (36.5%), $3.5M (27.9%), and $2.9M (23.1%) of Medicaid revenue, highlighting a narrow set of services that drive the practice’s financial performance.

The provider’s code-level competitive standing in-state is prominent for multiple high-revenue lines: D8020 (1.3K claims, $2611 avg paid/claim, $3.5M revenue) and D8090 (1.6K claims, $1841 avg paid/claim, $2.9M revenue) each rank #1 in-state and are listed at the 100th percentile, indicating the practice is a dominant statewide biller for these services. D8670 (18.8K claims, $244 avg paid/claim, $4.6M revenue) ranks #2 of 20 providers and sits at the 95th percentile, further underscoring the provider’s high relative volume on its top revenue drivers.

A notable additional revenue contributor is D8660 (3.8K claims, $372 avg paid/claim, $1.4M revenue; 11.4% of Medicaid revenue) which also ranks #1 of 14 providers at the 100th percentile. Although not in the precomputed top three by share, D8660’s size and top-in-state rank signal another area where this office leads peers in Medicaid billing volume.

Operational profile: the provider’s taxonomy is Orthodontics and Dentofacial Orthopedics Dentistry and the observed code mix — heavily weighted to a few specialty codes rather than broad general-dentistry CPT diversity — is consistent with a focused orthodontic practice model where a limited set of orthodontic/procedural services dominate revenue. The presence of D0150 (D0150 – Comprehensive oral evaluation – new or established patient) at 1.2K claims, $49 avg paid/claim, $58.2K revenue (0.5% of Medicaid revenue) and ranking #32 of 147 providers (79th percentile) suggests the practice still performs some general evaluation activity, but those services constitute a very small share of overall revenue.

There are several statistical and billing items that stand out as atypical: D8703 and D8704 each appear only at this provider in-state (138 claims/$37.5K and 135 claims/$36.6K respectively) with rank #1 of 1 and no state peer volume comparison available, indicating unique provision of those codes locally. Additionally, D0601 shows 1.2K claims with $0 avg paid/claim and $0 revenue, which may reflect administrative, coverage, or payment characteristics for that code rather than revenue contribution.

Tenure and market implications: the provider’s NPI was enumerated 2015-12-17 (~11 years ago), indicating an established presence in the state market. Given the heavy Medicaid concentration and the fact that the top three codes account for 87.5% of Medicaid revenue, the practice’s financial performance and negotiating position with payers will be especially sensitive to Medicaid policy, reimbursement changes, and any shifts in demand for those specific high-volume codes.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D8670	N/A	18,770	$240	$4.6M
D8020	N/A	1,340	$2,610	$3.5M
D8090	N/A	1,580	$1,840	$2.9M
D8660	N/A	3,850	$370	$1.4M
D0150	Comprehensive oral evaluation – new or established patient	1,190	$50	$58.2K
D8703	N/A	140	$270	$37.5K
D8704	N/A	140	$270	$36.6K
D0601	N/A	1,180	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Ahl And O'connor Orthodontics, LLC — 3 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D8670	N/A	2	20	2,720	$230	$1.2M
D8020	N/A	1	10	120	$2,450	$950.3K
D8090	N/A	1	10	200	$1,910	$774.6K
D8660	N/A	1	10	810	$330	$422.7K
D0150	Comprehensive oral evaluation – new or established patient	32	150	260	$60	$53.2K
D8703	N/A	1	10	140	$270	$37.5K
D8704	N/A	1	10	140	$270	$36.6K
D0601	N/A	15	80	170	$1	$10

Nearby Providers

Other providers in the same ZIP code as Ahl And O'connor Orthodontics, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayhealth Medical Center, Inc.	DE	General Acute Care Hospital	$0	$79.3M
Bayhealth Emergency Physicians LLC	DE	Emergency Medicine Physician	$0	$16.7M
Bayhealth Medical Center, Inc	DE	Colon & Rectal Surgery Physician	$0	$12.4M
State Of Delaware	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.2M
The Children's Secret Garden	DE	Medically Fragile Infants and Children Day Care	$0	$8.1M
Apogee Medical Group, Delaware, Inc	DE	Internal Medicine Physician	$0	$7.9M
First State Oral And Maxillofacial Surgery Corp	DE	Oral and Maxillofacial Surgery (Dentist)	$0	$5M
Jamie Ahl	DE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$4.9M
Kent Diagnostic Radiology Associates PA	DE	Diagnostic Radiology Physician	$0	$4.6M
The Mind And Body Consortium, LLC.	DE	Psychiatry Physician	$0	$3.9M

Ahl And O'connor Orthodontics, LLC — Billing Profile & Reimbursement Data

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Ahl And O'connor Orthodontics, LLC — Billing Profile & Reimbursement Data

Sign up for Ahl And O'connor Orthodontics, 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