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.

Wilmington Pediatric Dentistry PA (NPI 1285331603)

Field	Value
Entity Type	Organization
Organization	Wilmington Pediatric Dentistry PA
Address	Wilmington Pediatric Dentistry
City	Wilmington
State	DE
ZIP	19808
Taxonomy	Pediatric Dentistry
NPI Enumerated	February 15, 2023

Payer Source	Total Paid
Medicaid	$130.4K
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
D1120	Prophylaxis–child	490	$50	$24.2K
D1351	Sealant - per tooth	440	$40	$16.2K
D0150	Comprehensive oral evaluation – new or established patient	260	$60	$15.3K
D2930	N/A	50	$270	$13.4K
D0240	N/A	380	$30	$11.3K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	60	$160	$9.1K
D1208	Topical application of fluoride - excluding varnish	290	$30	$7.6K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	260	$30	$7.4K
D2391	Resin‑based composite – one surface, posterior	30	$230	$6.7K
D0272	N/A	140	$40	$5.1K

Showing 1–10 of 19

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

Wilmington Pediatric Dentistry PA — 0 of 17 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	22	30	580	$260	$446.8K
D1351	Sealant - per tooth	50	70	1,690	$40	$217.1K
D2391	Resin‑based composite – one surface, posterior	61	70	320	$180	$192K
D1120	Prophylaxis–child	74	120	960	$50	$163.3K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	45	60	270	$140	$137K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	93	130	1,220	$30	$116.9K
D0120	Periodic oral evaluation - established patient	125	160	800	$40	$110.5K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	151	160	330	$60	$82.3K
D0240	N/A	14	20	510	$30	$76.3K
D0272	N/A	57	80	430	$40	$71.6K

Showing 1–10 of 19

Wilmington Pediatric Dentistry PA — Billing Profile & Reimbursement Data

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Wilmington Pediatric Dentistry PA — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Frequently Asked Questions

References