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-1, PC (NPI 1477630556)

Field	Value
Entity Type	Organization
Organization	East 53rd Street Dental-1, PC
Address	3658 S East St
City	Indianapolis
State	IN
ZIP	46227
Taxonomy	General Practice Dentistry
NPI Enumerated	November 1, 2006

Payer Source	Total Paid
Medicaid	$7.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2930	N/A	10,910	$120	$1.3M
D1351	Sealant - per tooth	43,170	$20	$992.8K
D1120	Prophylaxis–child	25,410	$30	$686K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	27,940	$20	$530.9K
D0120	Periodic oral evaluation - established patient	26,680	$20	$506.9K
D0272	N/A	21,830	$20	$414.8K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	9,010	$40	$333.5K
D2140	Amalgam - one surface, primary or permanent	7,250	$50	$333.3K
D9230	N/A	12,720	$20	$305.3K
D2150	Amalgam - two surfaces, primary or permanent	4,060	$60	$259.5K

Showing 1–10 of 27

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-1, PC — 16 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

27 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	13	170	1,180	$130	$370.2K
D1354	N/A	74	130	700	$70	$252.9K
D1351	Sealant - per tooth	11	450	780	$20	$118.4K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	67	540	460	$70	$106.9K
D3220	N/A	22	90	240	$90	$90K
D1120	Prophylaxis–child	15	970	450	$30	$69K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	25	1,230	660	$40	$67K
D2150	Amalgam - two surfaces, primary or permanent	10	150	200	$60	$66.2K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	14	750	530	$20	$56.9K
D2140	Amalgam - one surface, primary or permanent	5	110	260	$50	$56.7K

Showing 1–10 of 27

Related Providers

Other providers that share a Tax Identification Number (TIN) with East 53rd Street Dental-1, 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-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
East 53rd Street Dental-3, PC	IN	General Practice Dentistry	$0	$3.3M

Nearby Providers

Other providers in the same ZIP code as East 53rd Street Dental-1, PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Adult And Child Center, Inc	IN	Community/Behavioral Health Agency	$0	$114.1M
Community Hospital South, Inc.	IN	General Acute Care Hospital	$0	$27.3M
Adult And Child Mental Health Center Inc	IN	Community/Behavioral Health Agency	$0	$23.5M
Adult And Child Mental Health Center Inc	IN	Federally Qualified Health Center (FQHC)	$0	$10.7M
Emergency Dentist,llc	IN	General Practice Dentistry	$0	$9.3M
Spero Health Of Indiana, LLC	IN	Addiction Medicine (Family Medicine) Physician	$0	$8.6M
Freedom Home Care, LLC.	IN	Home Health Agency	$0	$7.4M
City Optical Co., Inc.	IN	Optometrist	$0	$6.5M
Windrose Health Network, Inc.	IN	Federally Qualified Health Center (FQHC)	$0	$6M
City Optical Co., Inc.	IN	Optometrist	$0	$6M

East 53rd Street Dental-1, PC — Billing Profile & Reimbursement Data

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East 53rd Street Dental-1, PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References