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

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

Pediatric Dentistry LLC (NPI 1265848774)

Field	Value
Entity Type	Organization
Organization	Pediatric Dentistry LLC
Address	1439 Stillwater Ave Ste 7
City	Cheyenne
State	WY
ZIP	82009
Taxonomy	Pediatric Dentistry
NPI Enumerated	July 3, 2014

Payer Source	Total Paid
Medicaid	$4.1M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused practice: total Medicaid revenue is $4.1M and there is no Medicare billing on file, so payer exposure is concentrated entirely in Medicaid. That single-payer profile means changes in state Medicaid policy or reimbursement could have outsized impact on overall revenues.

Revenue concentration is high: the precomputed top 3 Medicaid codes by revenue account for 46.3% of the provider's total Medicaid revenue, with D1206, D0120, and D1120 as the principal drivers. Those three codes are all preventive/recall services (topical fluoride, periodic evaluation, and child prophylaxis), indicating the bulk of revenue derives from routine preventive care rather than high-dollar restorative procedures.

The code mix and volumes strongly indicate a pediatric-centered service line. High volumes for D1206 (20.3K claims, $671.4K revenue), D1120 (17.2K claims, $584.1K revenue), and D1351 (9.1K claims, $256.1K revenue) point to a throughput model emphasizing fluoride, child prophylaxis, and sealants typical of pediatric dentistry clinics. The presence of large claim counts for D0220 and D0230 (14.4K and 14.3K claims respectively) further suggests routine radiographic imaging is a regular part of visits.

This provider is a dominant statewide performer for several codes: D0220 and D0230 both rank #1 in-state (100th percentile) and D1206, D0120, and D1120 each rank #2 in-state at the 99th percentile and are labeled as extreme outliers. Those rankings indicate market-leading volume for radiographic and preventive pediatric services relative to other Wyoming providers, consistent with a major statewide presence in these service lines.

While the practice is pediatric-focused, it also bills a nontrivial volume of adult prophylaxis: D1110 shows 7.2K claims and $354.7K in revenue (8.7% of Medicaid revenue), indicating that some adult preventive care is provided under Medicaid in addition to the dominant pediatric mix. This mix suggests some service diversification within preventive dentistry, though pediatric codes still dominate revenue.

Several mid-range restorative and operative codes appear as notable contributors but are less dominant: D2391, D2392, and D2930 together represent meaningful but smaller shares of revenue and are typically ranked in the mid-to-high percentiles (e.g., D2391 ranks #2 of 22 at the 95th percentile). These entries imply the practice performs restorative work at scale, but restorative services are secondary to preventive and diagnostic workflows.

Operationally, the extremely high counts for intraoral periapical images (D0220 14.4K claims; D0230 14.3K claims) and large sealant and prophylaxis volumes imply a high-throughput clinic with substantial imaging and preventive-capacity requirements. That pattern has implications for staffing, radiography equipment, and appointment throughput strategies typical of high-volume pediatric dental operations.

The NPI was enumerated on 2014-07-03 (~12 years ago), indicating an established presence in Cheyenne; combined with consistent top-state ranks and large Medicaid revenue, this suggests sustained, market-leading pediatric dental activity rather than a recent or transient billing spike. Given the concentration in a small number of preventive codes and complete reliance on Medicaid, the provider’s revenue profile is significant for payers to monitor for network planning and reimbursement policy sensitivity.

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	20,350	$30	$671.4K
D0120	Periodic oral evaluation - established patient	20,670	$30	$640.7K
D1120	Prophylaxis–child	17,180	$30	$584.1K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	7,240	$50	$354.7K
D1351	Sealant - per tooth	9,150	$30	$256.1K
D2930	N/A	1,770	$130	$224.2K
D2391	Resin‑based composite – one surface, posterior	2,880	$70	$207.2K
D0220	Intraoral - periapical first radiographic image	14,380	$10	$201.4K
D0230	Intraoral - periapical each additional radiographic image	14,290	$10	$200.1K
D2392	Post 2 surface resin‑based composite	2,120	$90	$193.2K

Showing 1–10 of 20

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wyoming Distribution

Pediatric Dentistry LLC — 9 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	3	10	810	$130	$141.9K
D2392	Post 2 surface resin‑based composite	5	30	230	$90	$87.4K
D1351	Sealant - per tooth	3	30	200	$30	$64.6K
D2391	Resin‑based composite – one surface, posterior	2	20	140	$70	$56.9K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	2	100	130	$30	$46.4K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	5	20	300	$70	$40.1K
D1120	Prophylaxis–child	2	100	110	$30	$39.8K
D9420	N/A	5	10	140	$130	$37.4K
D0120	Periodic oral evaluation - established patient	2	130	170	$30	$36.9K
D9230	N/A	7	20	360	$20	$35.9K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Matthew Henry	WY	Pediatric Dentistry	$0	$8.6K

Nearby Providers

Other providers in the same ZIP code as Pediatric Dentistry LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Dentistry LLC	WY	Pediatric Dentistry	$0	$8M
Emg Cheyenne Sh LLC	WY	Assisted Living Facility	$0	$5.8M
Liv In-home Counseling & Care Management, LLC	WY	Primary Care Clinic/Center	$0	$5.7M
Lucy Russell	WY	Developmentally Disabled Services Day Training Agency	$0	$5.4M
Bridges Of Wyoming, Inc	WY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$2.2M
Renee Dreher	WY	Clinical Social Worker	$0	$817.9K
Breanna Barnes	WY	Pediatric Dentistry	$0	$794.4K
College Drive Urgent Care LLC	WY	Urgent Care Clinic/Center	$0	$770.4K
Sandra Surbrugg	WY	Dermatology Physician	$664.9K	$0
Center For Dermatologic Surgery	WY	Ambulatory Surgical Clinic/Center	$656.4K	$0

Pediatric Dentistry LLC — Billing Profile & Reimbursement Data

Sign up for Pediatric Dentistry LLC — Billing Profile & Reimbursement Data policy alerts

Pediatric Dentistry LLC — Billing Profile & Reimbursement Data

Sign up for Pediatric Dentistry 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

Related Providers

Nearby Providers

Frequently Asked Questions

References