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

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

Pda Ortho Specialty (NPI 1588950661)

Field	Value
Entity Type	Organization
Organization	Pda Ortho Specialty
Address	11 S Mill St
City	New Castle
State	PA
ZIP	16101
Taxonomy	Orthodontics and Dentofacial Orthopedics Dentistry
NPI Enumerated	June 27, 2011

Payer Source	Total Paid
Medicaid	$19M
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
D8670	N/A	35,820	$280	$10M
D8080	N/A	4,510	$800	$3.6M
D8030	N/A	24,150	$70	$1.7M
D0340	N/A	16,890	$70	$1.1M
D0330	N/A	19,300	$50	$964.8K
D8680	N/A	3,750	$200	$752.7K
D0150	Comprehensive oral evaluation – new or established patient	13,360	$30	$360.7K
D0350	N/A	19,590	$20	$293.8K
D0470	N/A	5,430	$30	$135.8K
D0140	Limited oral evaluation – problem focused	140	$20	$2.9K

Showing 1–10 of 18

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Pda Ortho Specialty — 9 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D8030	N/A	1	10	250	$70	$584K
D8670	N/A	1	250	310	$250	$253.5K
D8080	N/A	1	80	70	$980	$237.5K
D0340	N/A	1	20	50	$60	$63.3K
D8680	N/A	1	30	120	$170	$49.3K
D0470	N/A	1	10	500	$20	$40K
D2392	Post 2 surface resin‑based composite	904	960	190	$70	$35.1K
D8660	N/A	53	100	80	$100	$30.7K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	927	980	260	$20	$25K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	1,387	1,640	300	$30	$24.7K

Showing 1–10 of 18

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pda Ortho Specialty, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Professional Dental Alliance, LLC	OH	Dentist	$0	$54.1M

Nearby Providers

Other providers in the same ZIP code as Pda Ortho Specialty, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tri Medical Rehab Supply Corp.	PA	Durable Medical Equipment & Medical Supplies	$0	$28.8M
Don Services Inc	PA	Home Health Agency	$0	$27.6M
Professional Dental Alliance Of Indiana, LLC	PA	Dentist	$0	$17.5M
Discovery House Nc, LLC	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$221.1K	$13.4M
Community Alternatives, Inc.	PA	Clinic/Center	$0	$12.3M
Human Services Center	PA	Case Management Agency	$0	$7.4M
Human Services Center	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.1M
Caroline Daniels	PA	Family Medicine Physician	$30.2K	$99.1K
Joseph Stoner	PA	Anatomic Pathology & Clinical Pathology Physician	$27.9K	$0

Pda Ortho Specialty — Billing Profile & Reimbursement Data

Sign up for Pda Ortho Specialty — Billing Profile & Reimbursement Data policy alerts

Pda Ortho Specialty — Billing Profile & Reimbursement Data

Sign up for Pda Ortho Specialty — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References