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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Hero Dental Of Washington Dc PC (NPI 1679981005)

Field	Value
Entity Type	Organization
Organization	Hero Dental Of Washington Dc PC
Address	3401 Georgia Ave Nw
City	Washington
State	DC
ZIP	20010
Taxonomy	General Practice Dentistry
NPI Enumerated	July 29, 2014

Payer Source	Total Paid
Medicaid	$11.7M
Medicare	$0

Key Findings

This provider reports no Medicare billing on file and $11.7M in lifetime Medicaid revenue, making its public-facing payer footprint effectively single-payer Medicaid rather than a mixed Medicare/Medicaid practice. Analysts should treat Medicare activity as absent for competitive-comparison work and focus on Medicaid utilization and rate risk when profiling this entity.

Revenue is highly concentrated: the precomputed top three Medicaid codes (D8080, D0120, D1120) together account for 47.2% of the provider’s total Medicaid revenue. Those individual contributions are D8080 at $3.5M (29.9%), D0120 at $1M (8.9%), and D1120 at $978.3K (8.4%), making these three codes the primary revenue drivers to prioritize in service-line and contract analyses.

The code mix signals a high-volume preventive and basic restorative dental operation: large claim counts and payments for D0120 (32.6K claims), D1120 (22.8K claims), D1206 (34.9K claims), D1110 (12.6K claims), and D1351 (12.1K claims) point to heavy delivery of periodic exams, prophylaxis (pediatric and adult), topical fluoride and sealants. Restorative codes such as D2392 and D2391 also appear in the top revenue list, indicating routine posterior composite restorations are a meaningful secondary service line alongside prevention.

D8080 is the single largest revenue contributor at $3.5M with an average paid/claim of $3605, which is materially higher than routine prophylaxis and exam payments (for example, D0120 $32 avg paid/claim and D1120 $43 avg paid/claim). Despite its outsized share of revenue, D8080 ranks #2 of 7 providers in-state (83th percentile) and is described as typical/unremarkable in state volume, so its presence as a top revenue source appears to reflect high per-claim payments rather than uniquely dominant claim volume in-state.

This provider is a state-level volume leader on many preventive codes: D0120, D1120, D1206 and D1110 each rank in the 99th–98th percentiles and are labeled as extreme outliers or far above typical state volume. Multiple other codes (D0274, D0330, D2391, D0272, D1351) also sit with very high in-state percentiles and top-3 ranks, supporting characterization of the practice as a major regional player for routine exam, prophylaxis, fluoride, and common restorative services.

The NPI was enumerated 2014-07-29 (~12 years ago), indicating an established operating tenure in the market; combined with the high-volume Medicaid patterns, this suggests sustained presence and operational experience serving Medicaid populations. Tenure supports interpreting the current utilization profile as a stable practice pattern rather than a short-lived spike.

Operationally, the extremely large claim volumes for low-paid preventive codes (D0120 32.6K claims, D1120 22.8K claims, D1206 34.9K claims) imply a throughput-dependent business model that likely relies on scale and efficient patient flow to monetize Medicaid fee schedules. Stakeholders evaluating network adequacy, workforce needs, or contracting should expect a high-touch preventive/pediatric workflow and plan for capacity to manage many short, routine encounters.

Because the practice has no Medicare revenue and depends heavily on Medicaid (with 47.2% of Medicaid revenue coming from the top three codes), its revenue mix is concentrated and therefore sensitive to Medicaid reimbursement policy or eligibility changes. Payers and provider-relations teams should consider this concentration when modeling the financial impact of rate changes, prior-authorization rules, or program eligibility fluctuations on the provider’s Medicaid-dependent operations.

Medicaid: Complete Services Breakdown

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

33 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D8080	N/A	970	$3,610	$3.5M
D0120	Periodic oral evaluation - established patient	32,620	$30	$1M
D1120	Prophylaxis–child	22,750	$40	$978.3K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	34,860	$30	$941.1K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	12,600	$70	$881.8K
D0274	N/A	15,650	$40	$641.5K
D2392	Post 2 surface resin‑based composite	3,970	$140	$560.1K
D2391	Resin‑based composite – one surface, posterior	4,440	$110	$484K
D0272	N/A	13,780	$40	$482.2K
D1351	Sealant - per tooth	12,130	$40	$436.8K

Showing 1–10 of 33

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. District of Columbia Distribution

Hero Dental Of Washington Dc PC — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

33 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D8080	N/A	2	10	140	$2,640	$978.5K
D2930	N/A	6	20	260	$260	$322.7K
D2392	Post 2 surface resin‑based composite	7	80	230	$120	$148.6K
D1120	Prophylaxis–child	2	110	150	$40	$90.4K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	4	160	330	$60	$89.6K
D1351	Sealant - per tooth	2	30	390	$40	$87.3K
D2391	Resin‑based composite – one surface, posterior	4	60	200	$90	$86.2K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	2	70	180	$30	$66.9K
D0120	Periodic oral evaluation - established patient	2	180	320	$30	$63.7K
D0272	N/A	2	60	220	$30	$61.1K

Showing 1–10 of 33

Related Providers

Other providers that share a Tax Identification Number (TIN) with Hero Dental Of Washington Dc PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hero Dental Of Washington Dc PC	DC	General Practice Dentistry	$0	$19.3M
Hero Dental Of Washington Dc PC	DC	General Practice Dentistry	$0	$4.2M
Yvette Williams	DC	General Practice Dentistry	$0	$339K
Vida Loloei Marsal	DC	General Practice Dentistry	$0	$206.4K
Ritika Bansal	DC	Dentist	$0	$104.5K
Ihab Naga	DC	General Practice Dentistry	$0	$70.7K
Ahmed Tamim	DC	Oral and Maxillofacial Surgery (Dentist)	$0	$68.3K
Dominicque Gray	DC	General Practice Dentistry	$0	$61.5K
Sumati Kuntal	DC	General Practice Dentistry	$0	$54.5K
Danielle Smart	DC	General Practice Dentistry	$0	$28.3K

Nearby Providers

Other providers in the same ZIP code as Hero Dental Of Washington Dc PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital	DC	Children's Hospital	$0	$243.1M
Medstar Washington Hospital Center	DC	General Acute Care Hospital	$0	$239M
Children's Hospital	DC	Pediatrics Physician	$0	$115.3M
Whc Physician Group LLC	DC	General Practice Physician	$0	$93.8M
Medstar Medical Group Radiology, LLC	DC	Diagnostic Radiology Physician	$0	$17.5M
National Rehabilitation Hospital Inc	DC	Rehabilitation Hospital	$0	$16.9M
Medstar Heart Institute LLC	DC	Surgery Physician	$0	$4.8M
Bio-medical Applications Of Columbia Heights, Inc.	DC	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.6M
Washington Hospital Center Corp	DC	General Practice Physician	$0	$3.7M
Capital Area Renal Associates, PC	DC	Internal Medicine Physician	$0	$3.6M

Hero Dental Of Washington Dc PC — Billing Profile & Reimbursement Data

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Hero Dental Of Washington Dc PC — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References