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

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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.

Children's Dentistry Of The Lakes Region, PLLC (NPI 1285935866)

Field	Value
Entity Type	Organization
Organization	Children's Dentistry Of The Lakes Region, PLLC
Address	369 Hounsell Ave
City	Gilford
State	NH
ZIP	03249
Taxonomy	Dentist
NPI Enumerated	November 12, 2010

Payer Source	Total Paid
Medicaid	$16.7M
Medicare	$0

Key Findings

CHILDREN'S DENTISTRY OF THE LAKES REGION, PLLC is effectively a single‑payer Medicaid provider: there is no Medicare billing on file and lifetime Medicaid revenue is $16.7M, indicating the practice’s operations and scale are driven almost entirely by Medicaid patients rather than Medicare revenue streams. This concentration exposes the business to state Medicaid policy and reimbursement changes more than to Medicare market dynamics.

Revenue is concentrated in a small set of high-volume pediatric codes: the precomputed top three codes (D1120, D0120, D2930) account for 34.2% of the provider’s Medicaid revenue, with D1120 at $2.1M (12.9%), D0120 at $1.8M (10.9%), and D2930 at $1.7M (10.4%). This shows a heavy reliance on a few procedure types for a large share of revenue rather than a broad, evenly distributed service mix.

The code mix and descriptions point to a high-throughput pediatric dental model focused on preventive and routine care: leading codes include D1120 (Prophylaxis–child), D0120 (Periodic oral evaluation - established patient), D1351 (Sealant - per tooth), and high counts for topical fluoride codes (D1206, D1208). Simultaneously, notable volumes in restorative and surgical codes such as D2392, D2391, D7140 and amalgam codes (D2140, D2150) indicate the practice also delivers substantial restorative and extraction services for children.

Competitive standing within New Hampshire Medicaid is dominant for many codes: the provider ranks #1 of 162 for D1120 (100th percentile), #1 of 191 for D0120 (100th percentile), and holds #1 positions for multiple other high‑volume codes (for example, D2391, D1206, D7140, D0274, D0150, D0220, D0230 all rank #1 with 100th percentile or similar). Several of these are labeled as “extreme outlier” or “far above typical state volume,” which indicates the practice is an outlier and a regional leader in pediatric Medicaid dental volume.

Operationally the practice appears to run on large volumes of low‑unit Medicaid reimbursements: examples include D1120 with 57.4K claims at $37 avg paid/claim yielding $2.1M, D0120 with 60K claims at $30 avg paid/claim yielding $1.8M, and D1206 with 39.3K claims at $20 avg paid/claim yielding $785.5K. This pattern suggests a throughput and scheduling model optimized for high visit counts and routine procedures rather than reliance on fewer, high‑unit interventions.

High utilization of diagnostic imaging and anesthesia supports a full‑service pediatric operation: D0220 (8.5K claims, $10 avg, $85.2K) and D0230 (9.3K claims, $7 avg, $64.8K) both rank #1 in‑state (100th percentile), while anesthesia code 00170 has 1.8K claims at $241 avg ($438.6K, ranks #1 of 10) and is described as “notably above typical state volume.” Together these suggest frequent use of imaging and routine provision of anesthesia for intraoral procedures within the Medicaid population.

Several restorative codes are also present at scale and above typical state volume, indicating substantial operative casework beyond preventive services: D2392 ($1.6M, 9.7% of Medicaid revenue, ranks #3 of 62, 97th percentile, extreme outlier), D2391 ($1.1M, 6.8%, ranks #1 of 53, 100th percentile), and D2930 ($1.7M, 10.4%, ranks #2 of 14, 92th percentile, notably above typical). These figures point to a mix that includes both routine prevention and significant restorative demand in the patient population served.

The provider has an established market presence with an NPI enumerated on 2010-11-12 (~16 years ago), which combined with consistent high‑percentile rankings across many codes suggests a sustained, entrenched position in the state Medicaid pediatric dental market rather than a recent or sporadic increase in volume. Analysts should view this as a long‑standing, high‑volume Medicaid pediatric dental operation when assessing competitive dynamics and capacity in the region.

Medicaid: Complete Services Breakdown

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

36 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1120	Prophylaxis–child	57,440	$40	$2.1M
D0120	Periodic oral evaluation - established patient	60,030	$30	$1.8M
D2930	N/A	8,610	$200	$1.7M
D2392	Post 2 surface resin‑based composite	13,320	$120	$1.6M
D2391	Resin‑based composite – one surface, posterior	11,570	$100	$1.1M
D1351	Sealant - per tooth	33,140	$30	$928K
D9230	N/A	21,090	$40	$864.6K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	39,270	$20	$785.5K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	7,060	$100	$713.2K
D0274	N/A	21,930	$30	$701.8K

Showing 1–10 of 36

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Hampshire Distribution

Children's Dentistry Of The Lakes Region, PLLC — 18 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. New Hampshire median

36 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	2	10	590	$210	$535.2K
D2140	Amalgam - one surface, primary or permanent	2	10	520	$90	$223.9K
D2150	Amalgam - two surfaces, primary or permanent	2	10	140	$100	$180K
D1354	N/A	9	20	550	$20	$175.1K
D2392	Post 2 surface resin‑based composite	3	60	330	$110	$167.9K
D3220	N/A	2	10	80	$100	$157.1K
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	1	10	370	$240	$149.3K
D2391	Resin‑based composite – one surface, posterior	1	50	150	$100	$103.9K
D9230	N/A	1	40	710	$40	$96.9K
D1351	Sealant - per tooth	2	70	580	$30	$90.5K

Showing 1–10 of 36

Nearby Providers

Other providers in the same ZIP code as Children's Dentistry Of The Lakes Region, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Douglas Scott	NH	Ophthalmology Physician	$500.8K	$0
Horizons Counseling Center, Inc.	NH	Community/Behavioral Health Agency	$0	$263.5K
Bahder Behavioral Services LLC	NH	Psychiatry Physician	$0	$254.5K
David Parisi	NH	Clinical Social Worker	$11.2K	$175.4K
Cvs Manchester Nh, L.L.C.	NH	Pharmacy	$163.8K	$0
Stephen Catalano	NH	Clinical Child & Adolescent Psychologist	$0	$145.4K
Andrew Garfinkle	NH	Ophthalmology Physician	$143.8K	$0
Town Of Gilford	NH	Land Ambulance	$130.8K	$1.8K
Wal-mart Stores East LP	NH	Community/Retail Pharmacy	$100.4K	$0
Jacqueline Abikoff	NH	Addiction (Substance Use Disorder) Counselor	$0	$98K

Children's Dentistry Of The Lakes Region, PLLC — Billing Profile & Reimbursement Data

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Children's Dentistry Of The Lakes Region, PLLC — 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

Nearby Providers

Frequently Asked Questions

References