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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Kidskare P.C. (NPI 1316937964)

Field	Value
Entity Type	Organization
Organization	Kidskare P.C.
Address	1405 S Valley Dr Ste 200
City	Las Cruces
State	NM
ZIP	88005
Taxonomy	General Practice Dentistry
NPI Enumerated	October 25, 2005

Payer Source	Total Paid
Medicaid	$59M
Medicare	$0

Key Findings

KIDSKARE P.C. appears to be an almost exclusively Medicaid-focused dental practice: total Medicare revenue is listed as none while total Medicaid revenue is $59M, indicating Medicaid is effectively the sole payer driving the practice’s reported billing. This payer concentration implies operations and growth are tightly tied to state Medicaid policies and reimbursement schedules rather than Medicare patient volumes.

The provider’s top three Medicaid codes account for 35.7% of total Medicaid revenue, signaling a high revenue concentration in a few service lines. The highest-revenue code is D2392 (Post 2 surface resin‑based composite) with $8.2M (14.1% of Medicaid revenue), followed by D1120 (Prophylaxis–child) with $7M (12.0%), and D0150 (Comprehensive oral evaluation) with $5.6M (9.7%), which together indicate restorative and preventive pediatric-focused activity.

The code mix — dominated by D2392, D1120, and D0150 — suggests KIDSKARE operates at scale as a high-volume pediatric and general dental service provider that performs large numbers of prophylaxis visits, diagnostic evaluations, and posterior composite restorations. High volumes in D1208 (Topical application of fluoride) and D1351 (Sealant - per tooth) reinforce this interpretation of a strong preventive pediatric panel.

KIDSKARE is a statewide outlier across many Medicaid codes: the provider ranks #1 in-state for D2392, D1120, D0150, D2391, D1208 and numerous other codes, repeatedly at the 100th percentile and described as an "extreme outlier, far above typical state volume for this code." These rank/percentile indicators characterize the practice as a dominant in-state volume leader for routine dental and pediatric preventive/restorative services.

Several high-volume procedure lines combine both high counts and modest per-claim payments, e.g., D1120 with 217.7K claims at $32/claim and D1208 with 264.8K claims at $18/claim; this pattern implies a business model that relies on throughput and high patient visit counts rather than high unit reimbursement. At the same time, some higher-fee procedures such as D7210 ($113/claim) and D2930 ($118/claim) contribute meaningful ancillary revenue but represent far smaller claim volumes.

The provider has long-tenure in the NPI registry, enumerated on 2005-10-25 (~21 years ago), which, combined with its concentrated Medicaid revenue and dominant in-state ranks, suggests an established operation with sustained focus on Medicaid-covered dental services. This tenure supports the plausibility of the very high volumes reported rather than being a short-term spike.

Beyond the extreme outlier codes, a few codes show more typical in-state participation: for example, D2930 ranks #11 of 81 providers (88th percentile) and D3220 ranks #9 of 60 providers (86th percentile), which indicates that while the practice dominates many routine pediatric codes it is less exceptional for some higher-complexity endodontic and restorative services. These distinctions help separate high-throughput preventive/restorative lines from more specialized, lower-volume services.

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	112,100	$70	$8.2M
D1120	Prophylaxis–child	217,740	$30	$7M
D0150	Comprehensive oral evaluation – new or established patient	160,440	$40	$5.6M
D2391	Resin‑based composite – one surface, posterior	96,240	$60	$5.3M
D1208	Topical application of fluoride - excluding varnish	264,750	$20	$4.8M
D0274	N/A	127,090	$30	$3.8M
D0220	Intraoral - periapical first radiographic image	246,800	$10	$2.7M
D0120	Periodic oral evaluation - established patient	109,670	$20	$2.5M
D9230	N/A	80,750	$30	$2.2M
D0230	Intraoral - periapical each additional radiographic image	234,560	$10	$2.1M

Showing 1–10 of 39

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Kidskare P.C. — 23 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

39 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	11	80	870	$120	$456.1K
D3310	Endodontic therapy, anterior tooth (excluding final restoration)	3	10	4,370	$120	$450.1K
D7240	N/A	32	30	890	$190	$441K
D7510	N/A	1	10	1,370	$120	$193.4K
D3220	N/A	9	60	510	$90	$146.3K
D2392	Post 2 surface resin‑based composite	1	250	430	$70	$143.3K
D1120	Prophylaxis–child	1	380	330	$30	$137.6K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	3	110	300	$110	$111.3K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	1	200	290	$70	$91.7K
D9230	N/A	1	120	310	$30	$90.7K

Showing 1–10 of 39

Nearby Providers

Other providers in the same ZIP code as Kidskare P.C., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Direct Therapy Services, LLP	NM	Specialist	$0	$49.7M
Aprendamos Intervention Team	NM	Speech-Language Pathologist	$0	$45.2M
Grace Requires Understanding Inc.	NM	Specialist	$0	$37.9M
Casa De Esperanza, Inc	NM	In Home Supportive Care Agency	$0	$27.4M
America's Best Care	NM	In Home Supportive Care Agency	$0	$25.6M
Home Medical Equipment Specialists, LLC	NM	Durable Medical Equipment & Medical Supplies	$0	$23.8M
Tresco, Inc.	NM	Early Intervention Provider Agency	$0	$21.2M
Campo Behavioral Health, LLC	NM	Developmentally Disabled Services Day Training Agency	$0	$18.7M
American Medical Response Ambulance Service Inc	NM	Ambulance	$1.5M	$16.9M
La Clinica De Familia, Incorporated	NM	Federally Qualified Health Center (FQHC)	$0	$18.2M

Kidskare P.C. — Billing Profile & Reimbursement Data

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Kidskare P.C. — 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