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 Armed Forces Pacific for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Armed Forces Pacific 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. Armed Forces Pacific (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.

Mark Boone (NPI 1598741779)

Field	Value
Entity Type	Individual
Organization	Mark Boone
Address	Usndc Far East
City	Fpo
State	AP (Armed Forces Pacific)
ZIP	96350
Taxonomy	Pediatric Dentistry
NPI Enumerated	December 19, 2005

Payer Source	Total Paid
Medicaid	$13.4K
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively single-payer with respect to public programs: Total Medicare revenue is listed as none while total Medicaid revenue is $13.4K, indicating all recorded public-payer activity comes through Medicaid. Analysts should treat this entity as Medicaid-focused when assessing public-program financial exposure and network participation.

Medicaid revenue is highly concentrated: the precomputed top 3 Medicaid codes by revenue account for 77.5% of this provider's total Medicaid revenue. That concentration indicates that a small set of routine pediatric preventive and evaluation services drive the majority of the provider's public-revenue stream.

The top revenue-driving Medicaid code is D1120 (Prophylaxis–child), which accounts for $5K of revenue (37.5% of the provider's Medicaid total). This dominance of D1120, together with the presence of D1206 (topical fluoride) and D0120 (periodic oral evaluation) in the top three, points to a practice model focused on pediatric preventive dentistry and routine recall care rather than complex restorative or specialty procedures.

D1206 (Topical Fluoride Treatment) is the second major revenue contributor with $3K (22.2% of Medicaid revenue) and D0120 (Periodic oral evaluation) contributes $2.4K (17.7%). The mix of these three codes (together 77.5%) reinforces that the practice’s Medicaid caseload is centered on preventive services and established-patient evaluations, suggesting steady episodic visits rather than episodic high-cost interventions.

Competitive standing in-state is modest across the listed codes: this provider ranks #5 of 5 for D1120, #5 of 6 for D1206, and #6 of 6 for D0120, with percentiles at or near the bottom (0th and 20th percentiles noted). Those ranks indicate typical, unremarkable volume compared with in-state peers rather than dominance—this is a modest participant in the state Medicaid pediatric dentistry market.

Procedure-level volumes are consistent with a small pediatric practice: claim counts such as 264 claims for D1120, 297 for D1206, and 237 for D0120 together match the modest $13.4K Medicaid lifetime revenue and the code-level revenue amounts provided. The profile suggests routine throughput of children’s preventive visits rather than specialization or high-volume institutional throughput.

Radiographic and evaluation add-ons appear at low absolute levels: D0230 and D0220 collectively contribute under $1.5K and rank middling to low among in-state peers, which aligns with a preventive-focused workflow where limited imaging is billed per visit. Likewise, D0150 (comprehensive oral evaluation) appears rarely (13 claims, $533), supporting the interpretation that most encounters are periodic or prophylaxis visits rather than initial comprehensive exams.

Provider tenure is long-standing: the NPI was enumerated on 2005-12-19 (approximately 21 years ago). That tenure suggests the provider has an established presence in the local market despite modest Medicaid volumes, which may reflect a low-volume solo or small-group pediatric dental practice rather than a recent entrant or high-growth clinic.

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1120	Prophylaxis–child	260	$20	$5K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	300	$10	$3K
D0120	Periodic oral evaluation - established patient	240	$10	$2.4K
D0272	N/A	60	$20	$1.1K
D0230	Intraoral - periapical each additional radiographic image	90	$10	$740
D0220	Intraoral - periapical first radiographic image	80	$10	$670
D0150	Comprehensive oral evaluation – new or established patient	10	$40	$530

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Armed Forces Pacific providers billing the same CPT/HCPCS codes. Note: "AP" is a US military postal designation for Armed Forces stationed in the Asia-Pacific region — not a traditional US state; claims coded under it are benchmarked here as their own state-equivalent group.

Claims Volume vs. Armed Forces Pacific Distribution

Mark Boone — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Armed Forces Pacific

Full comparison — all codes billed, vs. Armed Forces Pacific median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D0120	Periodic oral evaluation - established patient	6	10	1,660	$30	$52.3K
D1120	Prophylaxis–child	5	10	1,740	$20	$36.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	5	10	1,080	$10	$13.3K
D0272	N/A	5	10	920	$10	$8.1K
D0150	Comprehensive oral evaluation – new or established patient	6	10	100	$20	$5.8K
D0220	Intraoral - periapical first radiographic image	6	10	200	$1	$4.4K
D0230	Intraoral - periapical each additional radiographic image	4	10	90	$1	$3.7K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stephanie Winslow	AP (Armed Forces Pacific)	Emergency Medicine Physician	$23.3K	$69.6K
Rose-valentine Goncalves	AP (Armed Forces Pacific)	Emergency Medicine Physician	$92.8K	$0
Seung Young Huh	AP (Armed Forces Pacific)	Emergency Medicine Physician	$13.1K	$0
Scott Naples	AP (Armed Forces Pacific)	Medical Physician Assistant	$7.5K	$0
Lauren Cruz	AP (Armed Forces Pacific)	Physical Therapist	$6.3K	$0

Mark Boone — Billing Profile & Reimbursement Data

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Mark Boone — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References