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

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

Madison Pediatric Dental, Sc (NPI 1538230966)

Field	Value
Entity Type	Organization
Organization	Madison Pediatric Dental, Sc
Address	100 River Pl
City	Madison
State	WI
ZIP	53716
Taxonomy	Pediatric Dentistry
NPI Enumerated	November 9, 2006

Payer Source	Total Paid
Medicaid	$2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2930	N/A	3,820	$150	$577K
D8670	N/A	4,970	$100	$506.9K
D1120	Prophylaxis–child	7,170	$30	$179.3K
D9230	N/A	3,590	$40	$147.2K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	8,130	$20	$121.9K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	1,800	$70	$117.2K
D0120	Periodic oral evaluation - established patient	6,850	$20	$116.4K
D1351	Sealant - per tooth	3,990	$20	$87.7K
D0272	N/A	4,650	$20	$79K
D9420	N/A	350	$180	$63.7K

Showing 1–10 of 18

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Madison Pediatric Dental, Sc — 0 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D8670	N/A	21	80	2,010	$110	$635.7K
D2930	N/A	14	80	410	$150	$427.7K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	58	220	430	$50	$111.4K
D1351	Sealant - per tooth	84	340	1,020	$20	$90.2K
D1120	Prophylaxis–child	42	520	460	$30	$62.6K
D9420	N/A	10	40	170	$200	$62.2K
D0120	Periodic oral evaluation - established patient	53	500	480	$20	$56K
D9230	N/A	11	120	300	$40	$54.8K
D3220	N/A	28	30	120	$80	$51.1K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	59	540	560	$10	$50.8K

Showing 1–10 of 18

Nearby Providers

Other providers in the same ZIP code as Madison Pediatric Dental, Sc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thomas Kuhn	WI	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$5.6M
Ashley Neiweem	WI	Ophthalmology Physician	$183.2K	$0
Walgreen Co	WI	Pharmacy	$161.5K	$11.7K
Jining Wang	WI	Dermatology Physician	$170.8K	$0
Caroline Schmitt	WI	Dermatology Physician	$165K	$0
Walgreen Co	WI	Pharmacy	$133.7K	$25.5K
John Kelly	WI	Allergy & Immunology Physician	$134.1K	$0
Nathan Jung	WI	Urology Physician	$89.6K	$0
Nicholas Streit	WI	Podiatrist	$88.2K	$0
Roger Kulstad	WI	Endocrinology, Diabetes & Metabolism Physician	$85.2K	$0

Madison Pediatric Dental, Sc — Billing Profile & Reimbursement Data

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Madison Pediatric Dental, Sc — Billing Profile & Reimbursement Data

Sign up for Madison Pediatric Dental, Sc — 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