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

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

Montshire Sanford PC (NPI 1235839077)

Field	Value
Entity Type	Organization
Organization	Montshire Sanford PC
Address	955 Main St
City	Sanford
State	ME
ZIP	04073
Taxonomy	Pediatric Dentistry
NPI Enumerated	March 9, 2023

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1354	N/A	14,180	$20	$340.3K
D1351	Sealant - per tooth	10,900	$30	$316K
D1120	Prophylaxis–child	3,100	$40	$136.3K
D2940	N/A	2,240	$50	$118.7K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	3,520	$20	$80.9K
D0120	Periodic oral evaluation - established patient	2,190	$30	$63.4K
D1355	N/A	2,870	$20	$54.5K
D0150	Comprehensive oral evaluation – new or established patient	840	$60	$48.4K
D1310	N/A	1,800	$30	$45.1K
D0272	N/A	1,340	$30	$41.5K

Showing 1–10 of 19

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maine Distribution

Montshire Sanford PC — 1 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	8	20	230	$140	$315.1K
D1351	Sealant - per tooth	13	80	1,040	$20	$87.6K
D1120	Prophylaxis–child	30	160	500	$30	$56.2K
D2940	N/A	4	20	400	$50	$50.1K
D0120	Periodic oral evaluation - established patient	29	140	480	$20	$46.8K
D1354	N/A	1	50	620	$20	$43.9K
D0150	Comprehensive oral evaluation – new or established patient	30	100	310	$50	$39.3K
D0330	N/A	42	110	240	$40	$36.8K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	68	160	300	$40	$34.6K
D0140	Limited oral evaluation – problem focused	69	110	460	$20	$33.2K

Showing 1–10 of 19

Nearby Providers

Other providers in the same ZIP code as Montshire Sanford PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Waypoint Maine, Inc.	ME	Case Management Agency	$0	$110.5M
Great Bay Services	ME	Developmental Disabilities Clinic/Center	$0	$7.1M
Milestones Family Services, LLC	ME	Case Management Agency	$0	$2.8M
City Of Sanford	ME	Land Ambulance	$277.3K	$1.8M
Great Bay Services	ME	Developmental Disabilities Clinic/Center	$0	$824.9K
Philip Russell	ME	Psychiatry Physician	$14.5K	$720.3K
City Of Sanford	ME	Local Education Agency (LEA)	$0	$733.4K
Associated Eye Care, P.A.	ME	Optometrist	$0	$687.3K
Children's Dentistry Of Sanford, LLP	ME	Pediatric Dentistry	$0	$673.4K
Dana Graichen	ME	Ophthalmology Physician	$649.6K	$0

Montshire Sanford PC — Billing Profile & Reimbursement Data

Sign up for Montshire Sanford PC — Billing Profile & Reimbursement Data policy alerts

Montshire Sanford PC — Billing Profile & Reimbursement Data

Sign up for Montshire Sanford PC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References