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

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

Pediatric Dental Specialists Of Greater Nebraska, P.C. (NPI 1467553362)

Field	Value
Entity Type	Organization
Organization	Pediatric Dental Specialists Of Greater Nebraska, P.C.
Address	601 N St Joseph Ave
City	Hastings
State	NE
ZIP	68902
Taxonomy	Pediatric Dentistry
NPI Enumerated	September 26, 2006

Payer Source	Total Paid
Medicaid	$9.4M
Medicare	$0

Key Findings

PEDIATRIC DENTAL SPECIALISTS OF GREATER NEBRASKA, P.C. reports $9.4M in lifetime Medicaid revenue and has no Medicare billing on file, making its commercial footprint effectively absent in these datasets and its operations heavily Medicaid‑dependent. The lack of Medicare claims indicates this entity functions primarily within the pediatric Medicaid market rather than serving dual Medicare/Medicaid populations.

Revenue concentration is high: the precomputed top 3 Medicaid codes account for 49.2% of this provider's total Medicaid revenue. That level of concentration indicates a small set of procedure types (largely preventive and routine pediatric dentistry) drive nearly half of the practice’s Medicaid receipts.

Top revenue-driving codes point to a preventive, high-throughput pediatric model. D2930 (13.3K claims, $1.8M revenue) sits as the single largest Medicaid revenue source and ranks #1 of 48 providers in-state (100th percentile; extreme outlier), while D1206 (54.1K claims, $1.5M revenue) and D1120 (43.7K claims, $1.4M revenue) together make up the rest of the top-three mix, reflecting heavy volumes of topical fluoride and child prophylaxis services commonly associated with school‑age and preventive pediatric programs.

Claim counts and low average paid/claim values underscore high-volume, low-unit‑reimbursement activity: for example, D1206 shows 54.1K claims at $27 avg paid/claim and D1120 shows 43.7K claims at $31 avg paid/claim. This pattern is consistent with a volume-based pediatric preventive service line where overall revenue is driven by thousands of routine encounters rather than a smaller number of high-dollar procedures.

The provider also reports very large state‑level volumes on several evaluation and diagnostic codes, reinforcing a broad primary-care pediatric dental role: D0120 has 40.8K claims and $1.1M revenue and ranks #3 of 402 providers in-state (100th percentile; extreme outlier), while screening and radiographic codes such as D0240 (21.6K claims, $173.1K revenue) rank #1 of 32 providers (100th percentile; extreme outlier). These counts suggest the practice captures substantial share of routine exams and imaging within its region.

Restorative and surgical services are present but represent a smaller share of Medicaid revenue in absolute terms: examples include D2392 (4K claims, $351.5K revenue), D7140 (3.8K claims, $283K revenue), and D2391 (2.3K claims, $149.1K revenue). While these codes rank notably above typical state volume (percentiles in the 90s), their revenue totals are modest relative to the high-volume preventive codes, indicating a service mix weighted toward prevention with supplementary restorative and extraction work.

Competitive standing within Nebraska is pronounced: multiple codes rank at or near the top statewide (several #1 and multiple entries at #3–#5) and many entries are labeled “extreme outlier” or “notably above typical state volume,” reflecting dominant market share for several pediatric preventive services. This combination of top ranks and extreme outlier designations signals the provider is a major statewide player for pediatric Medicaid dentistry on a number of high-volume codes.

The practice has longstanding enrollment, with an NPI enumerated on 2006-09-26 (~20 years ago), indicating operational tenure that likely supports the scale and referral pathways needed to sustain the reported high claim volumes. Given the $9.4M Medicaid lifetime revenue, high volume preventive mix, and minimal Medicare presence, payer and network analysts should view this entity as an established, Medicaid-focused pediatric dental provider with concentrated revenue drivers and significant statewide competitive strength on key preventive codes.

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
D2930	N/A	13,320	$140	$1.8M
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	54,130	$30	$1.5M
D1120	Prophylaxis–child	43,680	$30	$1.4M
D0120	Periodic oral evaluation - established patient	40,810	$30	$1.1M
D1351	Sealant - per tooth	21,720	$30	$651.5K
D0272	N/A	28,800	$20	$431.9K
D1999	N/A	35,890	$10	$358.9K
D2392	Post 2 surface resin‑based composite	4,040	$90	$351.5K
D9230	N/A	8,720	$30	$287.8K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	3,770	$80	$283K

Showing 1–10 of 29

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Pediatric Dental Specialists Of Greater Nebraska, P.C. — 17 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	1	50	540	$120	$269K
D1351	Sealant - per tooth	4	130	460	$30	$84.7K
D2392	Post 2 surface resin‑based composite	5	140	270	$80	$66.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	3	320	460	$20	$62.2K
D1120	Prophylaxis–child	3	290	320	$30	$61K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	7	100	180	$60	$58.2K
D0120	Periodic oral evaluation - established patient	3	400	430	$20	$44.3K
D0145	N/A	3	50	80	$40	$36.5K
D9420	N/A	6	30	190	$80	$35.9K
D2391	Resin‑based composite – one surface, posterior	10	120	150	$60	$33.1K

Showing 1–10 of 29

Pediatric Dental Specialists Of Greater Nebraska, P.C. — 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

Frequently Asked Questions

References