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

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

Eric Nygard, Dds, PLLC (NPI 1366977720)

Field	Value
Entity Type	Organization
Organization	Eric Nygard, Dds, PLLC
Address	18737 Sorrel Springs Ln
City	Frenchtown
State	MT
ZIP	59834
Taxonomy	Dental Clinic/Center
NPI Enumerated	April 24, 2017

Payer Source	Total Paid
Medicaid	$6.6M
Medicare	$0

Key Findings

This provider is effectively single‑payer: there is no Medicare billing on file and all reported federal program revenue comes from Medicaid, which totals $6.6M. The absence of Medicare activity means analyses should treat ERIC NYGARD, DDS, PLLC as a Medicaid-focused dental clinic rather than a mixed Medicare/Medicaid practice for competitive comparisons.

The NPI was enumerated on 2017-04-24 (~9 years ago), indicating roughly nine years of enrollment activity under the current NPI and sufficient tenure to have established steady billing patterns in the state Medicaid program. Tenure of this length supports interpretation of the high-volume code patterns as persistent operational choices rather than a short-term anomaly.

Revenue is highly concentrated: the top three Medicaid codes account for 87.9% of this provider's Medicaid revenue. Specifically, D9223 generated $2.9M (43.6% of Medicaid revenue), D9999 generated $2.4M (36.7%), and D9222 generated $494.8K (7.6%). This concentration suggests a heavy reliance on a very small set of procedure codes for the majority of billed dollars.

Although code descriptions are not available in the dataset, the claim counts and average paid/claim values indicate a mix of higher‑paid, high‑volume procedures and lower‑paid supportive services. For example, D9223 has 6K claims at a $475 avg paid/claim and D9999 has 6.4K claims at $374 avg paid/claim, while D9222 and D9612 show 5.9K claims with $84 and $80 avg paid/claim respectively. This pattern is consistent with a dental clinic that captures most revenue from a few relatively higher‑paid procedure codes while also performing large volumes of lower‑unit‑price services.

For key revenue drivers the practice is a major statewide participant: D9223 ranks #2 of 25 providers in-state (96th percentile) and is described as notably above typical state volume, indicating near‑top provider status for that service. Similarly, D9222 ranks #2 of 22 (95th percentile) and D9310 ranks #3 of 39 (95th percentile), both also labeled notably above typical state volume — together these ranks indicate the provider is a dominant contributor to several Medicaid dental procedure volumes in Montana.

Not all high-revenue codes reflect exceptional statewide standing: D9999, despite producing $2.4M (36.7% of Medicaid revenue) from 6.4K claims, ranks #2 of only 5 providers in-state at the 75th percentile and is characterized as typical or unremarkable volume. Likewise, smaller‑revenue codes such as D9920 ($18.9K, 0.3% of revenue) rank in the middle deciles (9 of 28, 70th percentile), showing that some components of the provider's mix are ordinary compared with peers.

Multiple codes show consistent above‑typical volumes across the practice’s portfolio (D9223 96th, D9222 95th, D9310 95th, D9612 88th percentiles), which suggests the provider is not a one‑off outlier on a single code but operates at elevated scale across several Medicaid dental services. That breadth of above‑typical activity strengthens the interpretation that the clinic is an important Medicaid supplier for a set of dental procedures statewide.

The high revenue concentration in a few Medicaid codes creates both operational leverage and exposure: because D9223 and D9999 together make up 80.3% of Medicaid revenue (43.6% + 36.7%), changes to reimbursement, coverage policy, or peer competition for those specific codes could disproportionately affect overall revenue. Given the provider’s strong statewide rankings on several of those codes, payers and analysts should monitor reimbursement and utilization trends for these specific codes when assessing financial or contract negotiations.

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D9223	N/A	6,010	$480	$2.9M
D9999	N/A	6,440	$370	$2.4M
D9222	N/A	5,890	$80	$494.8K
D9612	N/A	5,890	$80	$471.1K
D9310	N/A	5,840	$50	$303.6K
D9920	N/A	370	$50	$18.9K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Eric Nygard, Dds, PLLC — 2 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D9999	N/A	2	10	280	$400	$1.1M
D9223	N/A	2	30	1,090	$250	$451.6K
D9222	N/A	2	20	1,380	$80	$164.8K
D9612	N/A	2	10	140	$80	$128.1K
D9310	N/A	3	40	450	$50	$74.1K
D9920	N/A	9	30	140	$80	$52.3K

Nearby Providers

Other providers in the same ZIP code as Eric Nygard, Dds, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Frenchtown School District #40	MT	Local Education Agency (LEA)	$0	$2.2M
Frenchtown Family Medical & Wellness, PC	MT	Family Nurse Practitioner	$0	$470.8K
Stacey Riffe	MT	Primary Care Nurse Practitioner	$39.4K	$0
Amy Schuster	MT	Family Nurse Practitioner	$30.8K	$0

Eric Nygard, Dds, PLLC — Billing Profile & Reimbursement Data

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Eric Nygard, Dds, PLLC — 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