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.

Children's Dental Health Of Delaware - Wilmington, PA (NPI 1316095904)

Field	Value
Entity Type	Organization
Organization	Children's Dental Health Of Delaware - Wilmington, PA
Address	708 Foulk Rd
City	Wilmington
State	DE
ZIP	19803
Taxonomy	Pediatric Dentistry
NPI Enumerated	January 8, 2007

Payer Source	Total Paid
Medicaid	$8M
Medicare	$0

Key Findings

This provider is effectively single‑payer: there is no Medicare billing on file and lifetime Medicaid revenue is $8M, so all reported fee‑for‑service activity in our dataset is driven by Medicaid patients and programs. The absence of Medicare activity limits cross‑payer comparisons and indicates the practice operates primarily in the pediatric Medicaid market.

Revenue is moderately concentrated: the precomputed top three Medicaid codes by revenue account for 34.2% of this provider's total Medicaid revenue, driven by D2392 ($1.1M, 14.4%), D1120 ($806.4K, 10.2%), and D0120 ($760.6K, 9.6%). Those three codes alone make up roughly one‑third of billed Medicaid dollars, signaling a focused set of revenue drivers.

The procedure mix is consistent with a high‑volume pediatric dentistry operation: large claim counts for preventive and child‑focused codes — D0120 with 19K claims, D1120 with 15.5K claims, D1351 sealants at 10.7K claims, and D1206 topical fluoride at 12.5K claims — indicate routine preventive care and sealant programs are core services. At the same time, meaningful revenue from restorative codes such as D2392 ($1.1M) and D2930 ($500.3K) plus extractions D7140 ($470.7K) shows the practice delivers the full continuum of pediatric restorative and surgical care.

Competitive standing within Delaware is strong on several high‑volume pediatric codes. D0120 ranks 6 of 158 (97th percentile) and is labeled an extreme outlier (far above typical state volume), and D1120 ranks 6 of 116 (96th percentile) as notably above typical state volume; similarly, D1208 ranks 1 of 51 (100th percentile) and is an extreme outlier, indicating the practice is a major statewide provider for routine preventive fluorides and evaluations. Conversely, D2392 ($1.1M, 14.4%) ranks 8 of 90 (92th percentile) and is described as typical/unremarkable in volume for that code, so the provider is less dominant on some restorative categories.

There are several high‑revenue codes without descriptions in the data that nonetheless represent important revenue lines: D9230 generated $514.3K and ranks 2 of 32 (97th percentile, notably above typical), while D9248 contributed $196.4K and ranks 2 of 2 (0th percentile). These items suggest non‑routine or higher‑value services substantially supplement preventive revenues and should be reviewed in context of coding and service mix.

Operationally, the combination of extremely high preventive visit counts (19K D0120; 15.5K D1120) and large sealant/fluoride volumes implies significant pediatric patient throughput and a workflow optimized for preventive outreach and recall. For payers, that mix typically maps to high capacity for delivering preventive care in Medicaid populations and potential leverage when structuring value‑based or preventive incentives.

Although the practice shows strong statewide positioning for preventive pediatric dentistry, it retains a balanced mix of restorative and surgical activity — D2392, D2930, and D7140 together represent substantial revenue portions of the $8M Medicaid total — which signals a full‑service pediatric dental operation rather than a prevention‑only clinic. Payers evaluating network adequacy should note both the high preventive volume and the material restorative/extraction capacity.

The NPI was enumerated on 2007-01-08 (~19 years ago), indicating long tenure in the market; combined with the high volumes and repeated extreme‑percentile rankings on preventive codes, this suggests an established practice with sustained Medicaid patient flow rather than a recent entrant or small intermittent operator.

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
D2392	Post 2 surface resin‑based composite	5,260	$220	$1.1M
D1120	Prophylaxis–child	15,510	$50	$806.4K
D0120	Periodic oral evaluation - established patient	19,020	$40	$760.6K
D9230	N/A	7,560	$70	$514.3K
D2930	N/A	2,180	$230	$500.3K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	6,710	$70	$476.7K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	3,020	$160	$470.7K
D1351	Sealant - per tooth	10,690	$40	$459.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	12,500	$30	$387.5K
D2391	Resin‑based composite – one surface, posterior	1,970	$180	$344.6K

Showing 1–10 of 39

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

Children's Dental Health Of Delaware - Wilmington, PA — 6 of 25 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

39 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	8	30	580	$260	$446.8K
D9248	N/A	2	10	1,590	$250	$400.2K
D2392	Post 2 surface resin‑based composite	8	90	490	$220	$366.3K
D2393	Resin-based composite, three surfaces, posterior	26	40	260	$270	$226.1K
D1351	Sealant - per tooth	10	70	1,690	$40	$217.1K
D2391	Resin‑based composite – one surface, posterior	13	70	320	$180	$192K
D1120	Prophylaxis–child	6	120	960	$50	$163.3K
D2390	N/A	2	10	90	$460	$140.8K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	6	60	270	$140	$137K
D9230	N/A	2	30	900	$70	$121.1K

Showing 1–10 of 39

Nearby Providers

Other providers in the same ZIP code as Children's Dental Health Of Delaware - Wilmington, PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Nemours Foundation	DE	Multi-Specialty Clinic/Center	$0	$172M
The Nemours Foundation	DE	Children's Hospital	$0	$104M
Jevs Human Services	DE	Adult Development & Aging Psychologist	$0	$84.4M
Christiana Care Home Health And Community Services, Inc.	DE	Home Health Agency	$0	$44.1M
Medexpress, Inc - Delaware	DE	Family Medicine Physician	$0	$7.9M
Radnon Home Care LLC	DE	In Home Supportive Care Agency	$0	$6.5M
Delaware Cardiovascular Associates, P.A.	DE	Cardiovascular Disease Physician	$0	$5.4M
Concord Dental, LLC	DE	Dental Clinic/Center	$0	$4.2M
Christiana Care Health Services Inc	DE	Student Health Clinic/Center	$0	$3.9M
Dental Management Strategies LLC	DE	Dentist	$0	$2.9M

Children's Dental Health Of Delaware - Wilmington, PA — Billing Profile & Reimbursement Data

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Children's Dental Health Of Delaware - Wilmington, PA — 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