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

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

Timberlane Dental Group (NPI 1326139130)

Field	Value
Entity Type	Organization
Organization	Timberlane Dental Group
Address	60 Timber Ln
City	South Burlington
State	VT
ZIP	05403
Taxonomy	Orthodontics and Dentofacial Orthopedics Dentistry
NPI Enumerated	September 27, 2006

Payer Source	Total Paid
Medicaid	$7.5M
Medicare	$0

Key Findings

This provider is effectively a single‑payer Medicaid billing entity: Total Medicare revenue shows none (no Medicare billing on file) while Total Medicaid revenue is $7.5M, indicating that Medicaid is the sole recorded public payer driving reported revenue. This concentration means most of the provider’s public reimbursement exposure and contracting leverage is tied to Medicaid policy and rates rather than Medicare.

Revenue is heavily concentrated in a small set of procedures: the precomputed top‑3 Medicaid codes (D1120, D0120, D2392) together account for 49.5% of the provider’s total Medicaid revenue. Those three codes individually represent 17.3% (D1120), 16.9% (D0120), and 15.3% (D2392) of Medicaid revenue, showing material dependence on a narrow set of pediatric preventive and restorative services.

The code mix indicates an operational focus on high‑volume pediatric preventive care and basic restorative work. D1120 (Prophylaxis–child: 33.1K claims) and D1206/D1208 (Topical Fluoride: 33.3K claims and 11.3K claims respectively) point to a strong pediatric prevention pipeline, while D2392 (Post 2 surface resin‑based composite: 8.9K claims) and D2391/D2930 restorative entries show substantive restorative throughput. This combination is consistent with a high‑volume community dental clinic or group practice that prioritizes routine child dental care alongside common restorative procedures.

The practice is a dominant statewide performer for multiple high‑revenue Medicaid codes. It ranks #1 in the state (100th percentile; labeled an extreme outlier) for D1120, D0120, D2392, D1206, D0272, D9230, D1208, D1330 and D9420 in their respective provider pools, and ranks highly for other evaluation and imaging codes (for example D0140 is #2 of 68 providers, 99th percentile). Those rank/percentile signals identify the provider as a major outlier in Vermont’s Medicaid dental market for core pediatric prevention and common restorative codes.

Volume and unit‑price signals reinforce the high‑throughput profile: D0120 shows 45.1K claims paid at $28 avg paid/claim yielding $1.3M revenue, D1120 shows 33.1K claims at $39 avg paid/claim yielding $1.3M revenue, and D1206 shows 33.3K claims at $23 avg paid/claim yielding $765K revenue. Those large claim counts combined with mid‑single‑digit to low‑hundreds dollar average payments per claim are consistent with a model that relies on scale and repeated preventive encounters to generate Medicaid revenue.

The provider’s taxonomy is Orthodontics and Dentofacial Orthopedics Dentistry but the billed service mix is dominated by general pediatric preventive and restorative dentistry rather than specialized orthodontic procedures. High ranks and volumes for codes such as D1120, D1206, D1351 (sealant), and common evaluation codes (D0140, D0150) suggest operational emphasis on routine pediatric dental visits and basic restorative procedures rather than elective orthodontic casework.

NPI tenure indicates established presence: NPI enumerated 2006-09-27 (~20 years ago), which supports interpretation of the high volumes and market position as the result of long‑standing service delivery rather than a recent entrant. That longevity may explain both referral patterns and the ability to sustain the sizable claim volumes recorded.

The combination of single‑payer Medicaid dependency ($7.5M with no Medicare billing on file) and revenue concentration (top‑3 codes = 49.5%) creates both bargaining power and exposure: the provider dominates specific Medicaid code volumes which could be advantageous in network contracting or program outreach, but the practice also carries concentration risk if state reimbursement policy or utilization controls target these high‑volume pediatric prevention and restorative codes. Analysts should treat the revenue base as highly Medicaid‑sensitive given the lack of Medicare diversification.

Medicaid: Complete Services Breakdown

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1120	Prophylaxis–child	33,110	$40	$1.3M
D0120	Periodic oral evaluation - established patient	45,120	$30	$1.3M
D2392	Post 2 surface resin‑based composite	8,930	$130	$1.1M
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	33,260	$20	$765K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	10,850	$50	$575K
D0272	N/A	17,580	$30	$457K
D9230	N/A	7,690	$60	$438.6K
D1351	Sealant - per tooth	7,950	$30	$254.3K
D0140	Limited oral evaluation – problem focused	6,130	$40	$251.1K
D0150	Comprehensive oral evaluation – new or established patient	5,120	$50	$230.2K

Showing 1–10 of 29

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Vermont Distribution

Timberlane Dental Group — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2392	Post 2 surface resin‑based composite	1	60	610	$130	$155.6K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	17	50	400	$80	$101.1K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	5	150	540	$50	$73.5K
D1351	Sealant - per tooth	5	40	480	$20	$63.9K
D2391	Resin‑based composite – one surface, posterior	7	50	310	$90	$62.9K
D9230	N/A	1	20	500	$50	$59.7K
D1120	Prophylaxis–child	1	110	220	$40	$59.2K
D0120	Periodic oral evaluation - established patient	1	160	720	$30	$57.8K
T1013	Sign language or oral interpretive services, per 15 minutes	12	10	300	$30	$54.3K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	1	120	500	$20	$53.5K

Showing 1–10 of 29

Nearby Providers

Other providers in the same ZIP code as Timberlane Dental Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nfi Vermont, Inc	VT	Clinic/Center	$0	$33.6M
Bla Partners, LLC	VT	Clinical Medical Laboratory	$0	$15.2M
Tms Vt, LLC	VT	Durable Medical Equipment & Medical Supplies	$0	$2.9M
Michelle Young	VT	Ophthalmology Physician	$2.1M	$0
Howard Center Inc	VT	Psychiatry Physician	$0	$2M
Vermont Eye Surgery & Laser Center	VT	Ambulatory Surgical Clinic/Center	$1.8M	$2.7K
David Weissgold	VT	Ophthalmology Physician	$1.7M	$0
Surgi-care Inc	VT	Prosthetic/Orthotic Supplier	$0	$1.7M
City Of So Burlington	VT	Ambulance	$400.9K	$1M
Green Mountain Pediatric Dentistry, PLLC	VT	Pediatric Dentistry	$0	$1.3M

Timberlane Dental Group — Billing Profile & Reimbursement Data

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Timberlane Dental Group — 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