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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Hero Dental Of Washington Dc PC (NPI 1285811224)

Field	Value
Entity Type	Organization
Organization	Hero Dental Of Washington Dc PC
Address	1060 Brentwood Rd. Ne
City	Washington
State	DC
ZIP	20018
Taxonomy	General Practice Dentistry
NPI Enumerated	January 22, 2008

Payer Source	Total Paid
Medicaid	$19.3M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and $19.3M in lifetime Medicaid revenue, so its observable commercial footprint in CMS data is effectively single-payer Medicaid. Analysts should treat Medicare as absent when evaluating payer mix, contract strategy, or risk exposure for this NPI.

Revenue is concentrated: the precomputed top three Medicaid codes account for 33.5% of this provider’s total Medicaid revenue. Those top three are D1120 with $2.3M (11.9%), D0120 with $2.2M (11.3%), and D1206 with $2M (10.3%), indicating a small set of high-volume services drive a large share of Medicaid receipts.

The code mix points to a high-volume preventive and pediatric practice model: D1120 (Prophylaxis–child) shows 51K claims at $45 avg paid/claim for $2.3M revenue, D0120 (Periodic oral evaluation) has 65.7K claims for $2.2M, and D1206 (Topical Fluoride Treatment) has 70.6K claims for $2M. In addition, D1110 (adult prophylaxis) at 23K claims and D1351 (sealant) at 17.6K claims reinforce that routine preventive care—especially for children—is a core service line.

Restorative and diagnostic throughput is substantial alongside prevention: D2392 (Post 2 surface resin-based composite) generates $1.6M from 10.7K claims, D2391 produces $803.7K from 7.2K claims, and radiographic codes D0272 (31.9K claims, $1.2M) and D0274 (24.7K claims, $1.1M) are high-volume contributors. This mix suggests the practice performs high-volume restorations and routine imaging in addition to prevention, supporting a throughput-oriented clinical operation.

The provider is a dominant statewide participant for many top codes: multiple high-volume codes rank #1 in-state (100th percentile) and are labeled as "extreme outlier," including D1120 (rank #1 of 106), D0120 (rank #1 of 184), D1206 (rank #1 of 72), D1110 (rank #1 of 159), D2392 (rank #1 of 80), D0272 (rank #1 of 60), D0274 (rank #1 of 139), D2391 (rank #1 of 61), and D1351 (rank #1 of 31). These rankings indicate a market-leading position in Medicaid-paid preventive and restorative pediatric services within the state.

A small number of high-dollar, lower-volume codes contribute materially to revenue: D8080 totals $1.7M from 372 claims at a $4561 avg paid/claim and ranks #3 of 7 providers in-state (67th percentile). The presence of D8080 and other less frequent, higher-paid codes suggests the practice also bills for complex or higher-cost procedures in smaller volumes.

The NPI was enumerated on 2008-01-22 (~18 years ago), indicating this is an established provider in the market; sustained, high-volume Medicaid billing across many codes combined with long tenure suggests operational stability and entrenched access to pediatric and routine dental Medicaid populations.

Several top codes are explicitly labeled as outliers or notably above typical state volume, which is meaningful for utilization review and contracting: a cluster of preventive and restorative codes are "extreme outlier" in state comparisons, while other codes such as D2930 and D9230 are described as "notably above typical" or in high percentiles. These statistical standings should prompt payers and network managers to review utilization patterns, capacity, and referral pathways when considering contracting or program interventions.

Medicaid: Complete Services Breakdown

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

39 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1120	Prophylaxis–child	50,970	$50	$2.3M
D0120	Periodic oral evaluation - established patient	65,670	$30	$2.2M
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	70,610	$30	$2M
D8080	N/A	370	$4,560	$1.7M
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	23,010	$70	$1.7M
D2392	Post 2 surface resin‑based composite	10,740	$150	$1.6M
D2930	N/A	5,410	$280	$1.5M
D0272	N/A	31,920	$40	$1.2M
D0274	N/A	24,730	$40	$1.1M
D2391	Resin‑based composite – one surface, posterior	7,180	$110	$803.7K

Showing 1–10 of 39

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. District of Columbia Distribution

Hero Dental Of Washington Dc PC — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

39 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D8080	N/A	3	10	140	$2,640	$978.5K
D2930	N/A	2	20	260	$260	$322.7K
D2392	Post 2 surface resin‑based composite	1	80	230	$120	$148.6K
D9223	N/A	7	10	160	$370	$100.2K
D1120	Prophylaxis–child	1	110	150	$40	$90.4K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	1	160	330	$60	$89.6K
D1351	Sealant - per tooth	1	30	390	$40	$87.3K
D2391	Resin‑based composite – one surface, posterior	1	60	200	$90	$86.2K
D2393	Resin-based composite, three surfaces, posterior	6	40	150	$140	$79.1K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	1	70	180	$30	$66.9K

Showing 1–10 of 39

Related Providers

Other providers that share a Tax Identification Number (TIN) with Hero Dental Of Washington Dc PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hero Dental Of Washington Dc PC	DC	General Practice Dentistry	$0	$11.7M
Hero Dental Of Washington Dc PC	DC	General Practice Dentistry	$0	$4.2M
Yvette Williams	DC	General Practice Dentistry	$0	$339K
Vida Loloei Marsal	DC	General Practice Dentistry	$0	$206.4K
Ritika Bansal	DC	Dentist	$0	$104.5K
Ihab Naga	DC	General Practice Dentistry	$0	$70.7K
Ahmed Tamim	DC	Oral and Maxillofacial Surgery (Dentist)	$0	$68.3K
Dominicque Gray	DC	General Practice Dentistry	$0	$61.5K
Sumati Kuntal	DC	General Practice Dentistry	$0	$54.5K
Danielle Smart	DC	General Practice Dentistry	$0	$28.3K

Nearby Providers

Other providers in the same ZIP code as Hero Dental Of Washington Dc PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
T & N Reliable Nursing Care,llc	DC	In Home Supportive Care Agency	$0	$103.2M
Immaculate Health Care Services,inc	DC	Respite Care	$0	$82.1M
Innovative Life Solutions, Inc.	DC	Developmental Disabilities Clinic/Center	$0	$73.3M
Nya Health Services Inc	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$39.6M
Life Stride, Inc.	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$19.4M
Goshen Healthcare & Management Services	DC	Community/Behavioral Health Agency	$0	$18.1M
P&g Behavioral Health Services LLC	DC	Adult Mental Health Clinic/Center	$0	$14.1M
Psychiatric Center Chartered,inc	DC	Psychiatry Physician	$0	$11.4M
Metropolitan Educational Solutions, LLC	DC	Case Management Agency	$0	$8.3M
Unity Health Care, Inc	DC	Federally Qualified Health Center (FQHC)	$0	$7.4M

Hero Dental Of Washington Dc PC — Billing Profile & Reimbursement Data

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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