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

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

East 53rd Street Dental-3, PC (NPI 1447559166)

Field	Value
Entity Type	Organization
Organization	East 53rd Street Dental-3, PC
Address	3701 S Main St Ste A150
City	Elkhart
State	IN
ZIP	46517
Taxonomy	General Practice Dentistry
NPI Enumerated	March 21, 2011

Payer Source	Total Paid
Medicaid	$3.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1351	Sealant - per tooth	17,900	$30	$465.3K
D1120	Prophylaxis–child	9,960	$30	$308.9K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	13,340	$20	$266.8K
D0120	Periodic oral evaluation - established patient	11,100	$20	$233.1K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	5,050	$50	$227.1K
D2150	Amalgam - two surfaces, primary or permanent	2,470	$70	$180K
D2930	N/A	1,340	$120	$155.1K
D0150	Comprehensive oral evaluation – new or established patient	4,810	$30	$154K
D0210	Intraoral - complete series of radiographic images	3,440	$40	$151.1K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	1,870	$80	$148K

Showing 1–10 of 31

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

East 53rd Street Dental-3, PC — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	77	170	1,180	$130	$370.2K
D7240	N/A	77	80	530	$270	$360.3K
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…	268	350	410	$150	$251K
D1351	Sealant - per tooth	32	450	780	$20	$118.4K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	132	540	460	$70	$106.9K
D3220	N/A	71	90	240	$90	$90K
D2392	Post 2 surface resin‑based composite	324	720	400	$60	$76.5K
D1120	Prophylaxis–child	63	970	450	$30	$69K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	87	1,230	660	$40	$67K
D2150	Amalgam - two surfaces, primary or permanent	23	150	200	$60	$66.2K

Showing 1–10 of 31

Related Providers

Other providers that share a Tax Identification Number (TIN) with East 53rd Street Dental-3, PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kool Smiles In-3, PC	IN	General Practice Dentistry	$0	$12.4M
East 53rd Street Dental-2, P.C.	IN	General Practice Dentistry	$0	$9M
Kool Smiles In Ft. Wayne, PC	IN	General Practice Dentistry	$0	$7.7M
East 53rd Street Dental-1, PC	IN	General Practice Dentistry	$0	$7.4M
East 53rd Street Dental-3, PC	IN	General Practice Dentistry	$0	$5.2M
East 53rd Street Dental-3, PC	IN	General Practice Dentistry	$0	$4.8M
East 53rd Street Dental-3, PC	IN	General Practice Dentistry	$0	$4.1M
James Homrighausen	IN	Oral and Maxillofacial Surgery (Dentist)	$0	$3.3M

Nearby Providers

Other providers in the same ZIP code as East 53rd Street Dental-3, PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Oaklawn Psychiatric Center, Inc.	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$46M
Oaklawn Psychiatric Center, Inc.	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$23.4M
Hewitt Dental Group Of Elkhart, Ltd.	IN	General Practice Dentistry	$0	$3.7M
Harley Yoder	IN	Family Medicine Physician	$81.6K	$0
Timothy Mcfadden	IN	Psychiatry Physician	$30.1K	$0
Timothy Quist	IN	Primary Podiatric Medicine Podiatrist	$25.8K	$0

East 53rd Street Dental-3, PC — Billing Profile & Reimbursement Data

Sign up for East 53rd Street Dental-3, PC — Billing Profile & Reimbursement Data policy alerts

East 53rd Street Dental-3, PC — Billing Profile & Reimbursement Data

Sign up for East 53rd Street Dental-3, PC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References