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

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

Junior Dover (NPI 1457406407)

Field	Value
Entity Type	Individual
Organization	Junior Dover
Address	1084 S State St
City	Dover
State	DE
ZIP	19901
Taxonomy	General Practice Dentistry
NPI Enumerated	January 23, 2007

Payer Source	Total Paid
Medicaid	$67.5K
Medicare	$0

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	430	$70	$28K
D2392	Post 2 surface resin‑based composite	50	$240	$12.9K
D0210	Intraoral - complete series of radiographic images	170	$60	$9.5K
D0120	Periodic oral evaluation - established patient	210	$40	$9K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	160	$30	$5.2K
D0150	Comprehensive oral evaluation – new or established patient	100	$20	$2K
D0274	N/A	20	$50	$940

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Junior Dover — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2392	Post 2 surface resin‑based composite	76	90	490	$220	$366.3K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	99	130	1,220	$30	$116.9K
D0120	Periodic oral evaluation - established patient	111	160	800	$40	$110.5K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	76	160	330	$60	$82.3K
D0274	N/A	107	130	330	$50	$57.4K
D0150	Comprehensive oral evaluation – new or established patient	92	150	260	$60	$53.2K
D0210	Intraoral - complete series of radiographic images	31	70	150	$70	$26.2K

Junior Dover — Billing Profile & Reimbursement Data

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Junior Dover — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Frequently Asked Questions

References