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

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

Medplex Pediatric Dentistry, Inc. (NPI 1518078674)

Field	Value
Entity Type	Organization
Organization	Medplex Pediatric Dentistry, Inc.
Address	4515 Southlake Pkwy
City	Birmingham
State	AL
ZIP	35244
Taxonomy	Pediatric Dentistry
NPI Enumerated	August 31, 2006

Payer Source	Total Paid
Medicaid	$3.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1120	Prophylaxis–child	17,920	$30	$501.8K
D0120	Periodic oral evaluation - established patient	24,280	$20	$461.2K
D7240	N/A	2,420	$170	$404.6K
D1208	Topical application of fluoride - excluding varnish	25,430	$20	$381.4K
D2392	Post 2 surface resin‑based composite	3,670	$70	$268.1K
D1999	N/A	13,450	$20	$255.6K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	6,430	$40	$237.8K
D1351	Sealant - per tooth	9,140	$20	$201.1K
D0272	N/A	12,240	$20	$195.8K
D0330	N/A	3,610	$50	$169.5K

Showing 1–10 of 28

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

Medplex Pediatric Dentistry, Inc. — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D7240	N/A	16	60	610	$180	$336.5K
D2930	N/A	56	120	1,240	$90	$233.9K
D1354	N/A	43	90	1,190	$20	$210.5K
D9222	N/A	21	50	430	$120	$172.6K
D2392	Post 2 surface resin‑based composite	48	280	520	$70	$144.9K
D9223	N/A	21	50	520	$90	$133K
D1120	Prophylaxis–child	35	520	810	$30	$104.3K
D2391	Resin‑based composite – one surface, posterior	78	250	380	$60	$91.8K
D1999	N/A	33	300	1,280	$20	$81.5K
D2393	Resin-based composite, three surfaces, posterior	50	90	170	$90	$78K

Showing 1–10 of 28

Nearby Providers

Other providers in the same ZIP code as Medplex Pediatric Dentistry, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$17.7M
Eh Health Hospice Of Alabama, LLC	AL	Community Based Hospice Care Agency	$0	$7.2M
Pediatric And Adolescent Dentistry, LLC	AL	Pediatric Dentistry	$0	$5.3M
Stratford Enterprises Inc	AL	Community Based Hospice Care Agency	$0	$4.7M
Elizabeth Perkins	AL	Rheumatology Physician	$2.9M	$0
William Thomas	AL	Pediatric Dentistry	$0	$2.1M
City Of Hoover	AL	Land Ambulance	$529.7K	$202K
Lauren Bannon	AL	Physician Assistant	$561.1K	$0
Diane Counce	AL	Neurology Physician	$501.8K	$0
Lindsay Kelmenson	AL	Rheumatology Physician	$413.9K	$0

Medplex Pediatric Dentistry, Inc. — Billing Profile & Reimbursement Data

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Medplex Pediatric Dentistry, Inc. — Billing Profile & Reimbursement Data

Sign up for Medplex Pediatric Dentistry, Inc. — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References