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

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

Toothworks PC (NPI 1306008800)

Field	Value
Entity Type	Organization
Organization	Toothworks PC
Address	19251 Mack Ave
City	Grosse Pointe Woods
State	MI
ZIP	48236
Taxonomy	General Practice Dentistry
NPI Enumerated	June 26, 2008

Payer Source	Total Paid
Medicaid	$21.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

37 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2930	N/A	22,430	$200	$4.5M
D1120	Prophylaxis–child	53,770	$40	$2.4M
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	56,320	$30	$1.6M
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	16,960	$90	$1.6M
D0120	Periodic oral evaluation - established patient	41,210	$40	$1.5M
D2392	Post 2 surface resin‑based composite	11,090	$130	$1.4M
D2391	Resin‑based composite – one surface, posterior	9,020	$100	$874.9K
D0140	Limited oral evaluation – problem focused	12,480	$60	$786.1K
D3220	N/A	5,570	$130	$724.2K
D1351	Sealant - per tooth	18,490	$30	$610K

Showing 1–10 of 37

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Toothworks PC — 19 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

37 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	3	200	660	$190	$434.6K
D2390	N/A	3	30	310	$200	$179.3K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	10	640	440	$70	$174K
D2392	Post 2 surface resin‑based composite	16	1,170	260	$110	$134.9K
D3220	N/A	5	160	230	$120	$102.7K
D1351	Sealant - per tooth	18	600	420	$30	$98K
D2391	Resin‑based composite – one surface, posterior	12	950	210	$80	$83.5K
D2393	Resin-based composite, three surfaces, posterior	431	540	130	$120	$74.4K
D1510	N/A	3	70	70	$210	$70.6K
D1354	N/A	10	100	470	$20	$65.2K

Showing 1–10 of 37

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Henry Ford Health St. John Hospital	MI	Internal Medicine Physician	$0	$41.8M
Emergency Department Physicians, P.C.	MI	Emergency Medicine Physician	$0	$41.2M
Eastpointe Radiologists, P.C.	MI	Diagnostic Radiology Physician	$0	$9.3M
Brightstar Counseling PLLC	MI	Psychiatry Physician	$0	$6.3M
Amr Aref	MI	Radiation Oncology Physician	$342.3K	$0
Eric Krutel	MI	Internal Medicine Physician	$236.1K	$0
Paul Chuba	MI	Radiation Oncology Physician	$230.5K	$0
Youssef Rizk	MI	Vascular Surgery Physician	$217.2K	$0
Douglas Piernick	MI	MOHS-Micrographic Surgery Physician	$177.2K	$0
Joseph Arbanas	MI	Foot & Ankle Surgery Podiatrist	$175.4K	$0

Toothworks PC — Billing Profile & Reimbursement Data

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Toothworks PC — Billing Profile & Reimbursement Data

Sign up for Toothworks PC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References