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

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

Tooth Fairy PC (NPI 1316203433)

Field	Value
Entity Type	Organization
Organization	Tooth Fairy PC
Address	121 E 31st St
City	Kearney
State	NE
ZIP	68847
Taxonomy	Pediatric Dentistry
NPI Enumerated	April 3, 2012

Payer Source	Total Paid
Medicaid	$523.8K
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
D2392	Post 2 surface resin‑based composite	1,200	$80	$89.6K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	3,850	$20	$88.5K
D1120	Prophylaxis–child	2,830	$30	$76.5K
D0120	Periodic oral evaluation - established patient	3,460	$20	$76.1K
D9230	N/A	1,710	$30	$49.6K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	990	$30	$33.5K
D1999	N/A	2,980	$10	$29.8K
D0220	Intraoral - periapical first radiographic image	2,770	$10	$16.6K
D0274	N/A	760	$20	$14.5K
D0272	N/A	1,030	$10	$13.4K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Tooth Fairy PC — 0 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	43	50	540	$120	$269K
D1351	Sealant - per tooth	80	130	460	$30	$84.7K
D2392	Post 2 surface resin‑based composite	31	140	270	$80	$66.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	48	320	460	$20	$62.2K
D1120	Prophylaxis–child	42	290	320	$30	$61K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	84	100	180	$60	$58.2K
D0120	Periodic oral evaluation - established patient	50	400	430	$20	$44.3K
D2391	Resin‑based composite – one surface, posterior	68	120	150	$60	$33.1K
D9230	N/A	15	90	260	$30	$32.2K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	71	310	220	$40	$28.1K

Showing 1–10 of 16

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Good Samaritan Hospital	NE	General Acute Care Hospital	$0	$9.8M
Alpha Rehabilitation, P.C.	NE	Rehabilitation Clinic/Center	$0	$1.2M
Overland Trails Renal Care Group, LLC	NE	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.1M
Michael Burke, Psy.d. And Associates, P.C.	NE	Mental Health Counselor	$0	$957.7K
Anne Marie Dale	NE	Professional Counselor	$0	$899.7K
Apollo Medflight, LLC	NE	Air Ambulance	$745.5K	$56.7K
First Care Medical, PC	NE	Clinic/Center	$0	$725.6K
Kearney Pain Treatment Center, LLC	NE	Ambulatory Surgical Clinic/Center	$620.3K	$0
Ryan Smith Counseling Services, LLC	NE	Mental Health Counselor	$0	$459K
Serene Mental Health Clinic LLC	NE	Adult Mental Health Clinic/Center	$0	$448.1K

Tooth Fairy PC — Billing Profile & Reimbursement Data

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

Tooth Fairy PC — Billing Profile & Reimbursement Data

Sign up for Tooth Fairy 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