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

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

William Mcdonald (NPI 1578671855)

Field	Value
Entity Type	Individual
Organization	William Mcdonald
Address	198 N Main St
City	Rutland
State	VT
ZIP	05701
Taxonomy	Dentist
NPI Enumerated	August 28, 2006

Payer Source	Total Paid
Medicaid	$194.9K
Medicare	$0

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D0140	Limited oral evaluation – problem focused	1,360	$40	$48.9K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	550	$50	$25.9K
D2392	Post 2 surface resin‑based composite	170	$120	$21.2K
D0120	Periodic oral evaluation - established patient	820	$20	$18.7K
D4355	N/A	230	$80	$18.4K
D0330	N/A	250	$60	$14.9K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	110	$100	$10.9K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	70	$150	$9.9K
D0220	Intraoral - periapical first radiographic image	530	$20	$9K
D0272	N/A	290	$20	$6.6K

Showing 1–10 of 15

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Vermont Distribution

William Mcdonald — 1 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	13	20	770	$140	$185K
D2392	Post 2 surface resin‑based composite	45	60	610	$130	$155.6K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	37	50	400	$80	$101.1K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	73	150	540	$50	$73.5K
D1120	Prophylaxis–child	107	110	220	$40	$59.2K
D0120	Periodic oral evaluation - established patient	73	160	720	$30	$57.8K
D0140	Limited oral evaluation – problem focused	19	70	560	$40	$53.3K
D0330	N/A	36	70	330	$60	$43.8K
D0150	Comprehensive oral evaluation – new or established patient	57	80	330	$40	$38.9K
D2393	Resin-based composite, three surfaces, posterior	29	30	110	$160	$37.1K

Showing 1–10 of 15

Nearby Providers

Other providers in the same ZIP code as William Mcdonald, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rutland Mental Health Services	VT	Developmental Disabilities Clinic/Center	$0	$122.1M
Community Health Centers Of The Rutland Region Inc	VT	Federally Qualified Health Center (FQHC)	$0	$20.6M
Rutland Mental Health Services, Inc.	VT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$17.7M
Rutland Hospital, Inc.	VT	Psychiatric Hospital Unit	$396.2K	$13.3M
Community Health Centers Of The Rutland Region, Inc.	VT	Pediatrics Physician	$0	$13.6M
Regional Ambulance Service, Inc	VT	Land Ambulance	$1.4M	$5.3M
Vna & Hospice Of The Southwest Region, Inc	VT	Home Health Agency	$0	$4.8M
Bradford Psychiatric Associates. LLC	VT	Addiction Medicine (Internal Medicine) Physician	$0	$4.7M
Community Health Centers Of The Rutland Region, Inc.	VT	Dentist	$0	$4.4M
Community Health Centers Of The Rutland Region, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$4.3M

William Mcdonald — Billing Profile & Reimbursement Data

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William Mcdonald — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References