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

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

The Smile Place (NPI 1669823886)

Field	Value
Entity Type	Organization
Organization	The Smile Place
Address	17 N Main St
City	Smyrna
State	DE
ZIP	19977
Taxonomy	Dentist
NPI Enumerated	June 29, 2016

Payer Source	Total Paid
Medicaid	$11.6M
Medicare	$0

Key Findings

THE SMILE PLACE is effectively a Medicaid-focused practice: it reports Total Medicaid revenue of $11.6M and has no Medicare billing on file. This makes the provider essentially single-payer in scale for public programs, with Medicaid driving the entirety of reported government revenue.

Revenue concentration is high: the precomputed top 3 Medicaid codes (D2392, D2391, D2393) account for 55.0% of the provider’s total Medicaid revenue. Those three codes individually are D2392 ($3.4M, 29.0% of Medicaid revenue), D2391 ($1.8M, 15.5%), and D2393 ($1.2M, 10.6%), indicating a heavy reliance on a narrow set of restorative services for the practice’s Medicaid income.

The service mix points to a high-volume restorative and pediatric/preventive operation: the top restorative codes are posterior resin composites (D2392, D2391, D2393), and preventive/diagnostic codes also show large volumes — D1120 (13K claims, $690.3K), D1351 (15.2K claims, $667.1K), and D0120 (14.3K claims, $584.5K). Together, these patterns suggest the practice delivers frequent routine exams, prophylaxis and sealants alongside a large number of posterior composite restorations.

THE SMILE PLACE is a dominant statewide provider for several high-revenue codes: D2391 ranks #1 of 69 providers in-state (100th percentile; extreme outlier) and D2392 ranks #2 of 90 providers in-state (99th percentile; extreme outlier). D2393 also ranks highly at #2 of 37 providers (97th percentile; notably above typical state volume), indicating the practice operates at an unusually large scale for these restorative services within Delaware.

High imaging and evaluation volumes support the high throughput impression: D0220 (13.3K claims, $318.8K), D0230 (14.2K claims, $283.9K), and D0210 (16 claims, $97 avg paid/claim) appear on the list, and D0120 (14.3K claims) and D0150 (3.7K claims, $246.1K) show frequent use of periodic and comprehensive exams. These numbers are consistent with a clinic model that performs many visits per patient and uses radiographs and evaluations routinely as part of care delivery.

There are notable statistical outliers beyond the core restorative mix: D9920 (no description available) is reported at 2.4K claims for $320.7K and ranks #1 of 21 providers in-state (100th percentile; extreme outlier). The presence of a high-volume, undefined code at top rank is operationally significant and merits attention from analysts when profiling service definitions and billing practices.

THE SMILE PLACE has a near-decade public enrollment history: NPI enumerated on 2016-06-29 (~10 years ago), giving it an established presence in the state market. Combined with the concentrated revenue mix and top-state rankings for core codes, tenure suggests the provider has scaled its Medicaid operations steadily since enumeration.

Medicaid: Complete Services Breakdown

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2392	Post 2 surface resin‑based composite	14,240	$240	$3.4M
D2391	Resin‑based composite – one surface, posterior	9,850	$180	$1.8M
D2393	Resin-based composite, three surfaces, posterior	4,070	$300	$1.2M
D1120	Prophylaxis–child	13,020	$50	$690.3K
D1351	Sealant - per tooth	15,160	$40	$667.1K
D0120	Periodic oral evaluation - established patient	14,260	$40	$584.5K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	5,310	$70	$377.3K
D9920	N/A	2,360	$140	$320.7K
D0220	Intraoral - periapical first radiographic image	13,280	$20	$318.8K
D0274	N/A	6,230	$50	$317.8K

Showing 1–10 of 30

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

The Smile Place — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	25	30	580	$260	$446.8K
D2392	Post 2 surface resin‑based composite	2	90	490	$220	$366.3K
D2940	N/A	2	10	2,340	$140	$322.4K
D2393	Resin-based composite, three surfaces, posterior	2	40	260	$270	$226.1K
D1351	Sealant - per tooth	8	70	1,690	$40	$217.1K
D2391	Resin‑based composite – one surface, posterior	1	70	320	$180	$192K
D1120	Prophylaxis–child	8	120	960	$50	$163.3K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	14	60	270	$140	$137K
D2394	N/A	3	10	180	$310	$123K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	21	130	1,220	$30	$116.9K

Showing 1–10 of 30

Nearby Providers

Other providers in the same ZIP code as The Smile Place, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Interim Healthcare Of Delaware LLC	DE	Intellectual & Developmental Disabilities Psychologist	$0	$51.8M
Maxim Healthcare Services, Inc.	DE	Home Health Agency	$0	$7.3M
Little Tooth Doctors LLC	DE	Pediatric Dentistry	$0	$939.2K
Delaware Medical Care PA	DE	Internal Medicine Physician	$0	$812.8K
Christiana Care Health Services Inc	DE	Urgent Care Clinic/Center	$0	$649.1K
Connections Community Support Programs, Inc.	DE	Adolescent and Children Mental Health Clinic/Center	$0	$615.1K
American Legion Ambulance Station 64 Inc	DE	Land Ambulance	$438.8K	$121.4K
Deborah Kirk	DE	Family Medicine Physician	$403.7K	$0
Deakyne, Dental Associates, P.A.	DE	General Practice Dentistry	$0	$401.1K
State Of Delaware	DE	Local Education Agency (LEA)	$0	$399.6K

The Smile Place — Billing Profile & Reimbursement Data

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The Smile Place — 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