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.

Joshua Francis (NPI 1295022820)

Field	Value
Entity Type	Individual
Organization	Joshua Francis
Address	51 E. North Street
City	Pinedale
State	WY
ZIP	82941
Taxonomy	Dentist
NPI Enumerated	July 4, 2011

Payer Source	Total Paid
Medicaid	$20K
Medicare	$0

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D0120	Periodic oral evaluation - established patient	360	$30	$11.3K
D1120	Prophylaxis–child	180	$30	$5.5K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	60	$30	$1.7K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	20	$60	$860
D0274	N/A	10	$40	$520
D1330	N/A	10	$10	$150

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

Joshua Francis — 0 of 6 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

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	68	100	130	$30	$46.4K
D1120	Prophylaxis–child	40	100	110	$30	$39.8K
D0120	Periodic oral evaluation - established patient	45	130	170	$30	$36.9K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	79	90	100	$50	$27.4K
D0274	N/A	59	60	140	$30	$14.3K
D1330	N/A	25	30	140	$1	$2.1K

Nearby Providers

Other providers in the same ZIP code as Joshua Francis, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sublette County Hospital District	WY	Paramedic	$196.2K	$0
County Of Sublette	WY	Public Health or Welfare Agency	$99.9K	$1.7K
Mark Weaver	WY	Physical Therapist	$67.3K	$0
Craig Hadfield	WY	Physical Therapist	$51.6K	$0
Christen Thonhoff	WY	Physical Therapist	$50.5K	$0
Amy Hughes	WY	Physical Therapist	$44K	$0
Andras Eder	WY	Family Medicine Physician	$33.4K	$0
Cori Wenz	WY	Medical Physician Assistant	$25.3K	$0
High Country Behavioral Health	WY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$21.9K
Keri Hull	WY	Family Nurse Practitioner	$20.6K	$0

Joshua Francis — Billing Profile & Reimbursement Data

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Joshua Francis — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References