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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Simply Smile PA (NPI 1427548353)

Field	Value
Entity Type	Organization
Organization	Simply Smile PA
Address	7457 Patterson Rd Ste 107
City	Columbia
State	SC
ZIP	29209
Taxonomy	Dental Clinic/Center
NPI Enumerated	May 16, 2018

Payer Source	Total Paid
Medicaid	$5.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2930	N/A	6,850	$130	$856.5K
D3220	N/A	7,230	$80	$585.2K
D2392	Post 2 surface resin‑based composite	4,060	$100	$409.7K
D9248	N/A	5,930	$70	$391.5K
D1120	Prophylaxis–child	10,440	$40	$365.4K
D0120	Periodic oral evaluation - established patient	12,420	$20	$285.6K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	5,490	$50	$274.4K
D9230	N/A	7,870	$30	$251.7K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	2,860	$90	$243.3K
D2391	Resin‑based composite – one surface, posterior	3,020	$80	$241.2K

Showing 1–10 of 26

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Carolina Distribution

Simply Smile PA — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. South Carolina median

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	10	130	1,060	$150	$371.1K
D2392	Post 2 surface resin‑based composite	35	350	520	$100	$175.3K
D1120	Prophylaxis–child	53	470	600	$30	$156.7K
D9248	N/A	6	50	920	$70	$126.1K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	32	290	380	$90	$125K
D9230	N/A	25	210	1,150	$30	$115.5K
D2391	Resin‑based composite – one surface, posterior	35	300	270	$80	$110.5K
D1351	Sealant - per tooth	27	200	840	$30	$108.9K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	49	590	850	$50	$104.9K
D0120	Periodic oral evaluation - established patient	51	610	1,060	$20	$100K

Showing 1–10 of 26

Nearby Providers

Other providers in the same ZIP code as Simply Smile PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Team Therapy Sc, LLC	SC	Speech-Language Pathologist	$0	$4.1M
A New Journey Healthcare & Senior Services	SC	In Home Supportive Care Agency	$0	$3.4M
Evelynn Pennington	SC	Primary Care Nurse Practitioner	$180.7K	$0
Brandon Roberg	SC	Clinical Psychologist	$98K	$0
Nicolette Ruta	SC	Optometrist	$68.7K	$0
Joseph Broudy	SC	Vascular & Interventional Radiology Physician	$64.2K	$0
Gregory Feldman	SC	Pulmonary Disease Physician	$49.4K	$0
Kezia Mcdaniel	SC	Family Nurse Practitioner	$37.1K	$2.8K
Caryn Melvin	SC	Speech-Language Pathologist	$32.2K	$0

Simply Smile PA — Billing Profile & Reimbursement Data

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Simply Smile PA — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References