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.

State Of Delaware (NPI 1316019185)

Field	Value
Entity Type	Organization
Organization	State Of Delaware
Address	417 Federal St
City	Dover
State	DE
ZIP	19901
Taxonomy	Dental Clinic/Center
NPI Enumerated	November 15, 2006

Payer Source	Total Paid
Medicaid	$401.8K
Medicare	$0

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1120	Prophylaxis–child	1,620	$60	$89.3K
D0150	Comprehensive oral evaluation – new or established patient	790	$70	$55.1K
D0120	Periodic oral evaluation - established patient	1,160	$40	$47.7K
D1208	Topical application of fluoride - excluding varnish	1,460	$30	$45.3K
D0272	N/A	960	$40	$35.5K
D0274	N/A	540	$50	$29.3K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	390	$70	$28.2K
D2392	Post 2 surface resin‑based composite	110	$200	$22.5K
D1351	Sealant - per tooth	460	$40	$20.2K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	560	$30	$18.3K

Showing 1–10 of 16

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

State Of Delaware — 0 of 13 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

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2392	Post 2 surface resin‑based composite	64	90	490	$220	$366.3K
D1351	Sealant - per tooth	48	70	1,690	$40	$217.1K
D2391	Resin‑based composite – one surface, posterior	58	70	320	$180	$192K
D1120	Prophylaxis–child	44	120	960	$50	$163.3K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	80	130	1,220	$30	$116.9K
D0120	Periodic oral evaluation - established patient	70	160	800	$40	$110.5K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	78	160	330	$60	$82.3K
D0272	N/A	24	80	430	$40	$71.6K
D0274	N/A	52	130	330	$50	$57.4K
D0330	N/A	80	100	190	$70	$54.1K

Showing 1–10 of 16

Nearby Providers

Other providers in the same ZIP code as State Of Delaware, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayhealth Medical Center, Inc.	DE	General Acute Care Hospital	$0	$79.3M
Bayhealth Emergency Physicians LLC	DE	Emergency Medicine Physician	$0	$16.7M
Ahl And O'connor Orthodontics, LLC	DE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$12.5M
Bayhealth Medical Center, Inc	DE	Colon & Rectal Surgery Physician	$0	$12.4M
State Of Delaware	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.2M
The Children's Secret Garden	DE	Medically Fragile Infants and Children Day Care	$0	$8.1M
Apogee Medical Group, Delaware, Inc	DE	Internal Medicine Physician	$0	$7.9M
First State Oral And Maxillofacial Surgery Corp	DE	Oral and Maxillofacial Surgery (Dentist)	$0	$5M
Jamie Ahl	DE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$4.9M
Kent Diagnostic Radiology Associates PA	DE	Diagnostic Radiology Physician	$0	$4.6M

State Of Delaware — Billing Profile & Reimbursement Data

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State Of Delaware — 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