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

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

Professional Dental Alliance, LLC (NPI 1740584226)

Field	Value
Entity Type	Organization
Organization	Professional Dental Alliance, LLC
Address	7043 Pearl Rd
City	Middleburg Heights
State	OH
ZIP	44130
Taxonomy	Dentist
NPI Enumerated	December 27, 2010

Payer Source	Total Paid
Medicaid	$54.1M
Medicare	$0

Key Findings

PROFESSIONAL DENTAL ALLIANCE, LLC is effectively a Medicaid-focused dental provider: it has no Medicare billing on file and reports $54.1M in lifetime Medicaid revenue, indicating a single-payer footprint concentrated on state Medicaid programs rather than Medicare fee-for-service. This payer mix implies operational emphasis on pediatric and adult Medicaid dental benefits and suggests revenue vulnerability to state Medicaid policy changes.

Revenue concentration is high among a small set of Medicaid codes: the precomputed top three Medicaid codes account for 25.6% of the provider’s total Medicaid revenue, signaling that a quarter of Medicaid dollars are driven by a limited group of high-volume procedural categories. That concentration suggests business sensitivity to reimbursement or utilization changes for those procedures.

The top individual Medicaid codes by revenue highlight a broad, high-volume general-dentistry practice mix: D2392, D3330, and D7140 are among the largest contributors (with D2392 at $4.6M, D3330 at $4.2M, and D7140 at $4.1M). Together with other leading codes like D1110 (adult prophylaxis) and D0140/D0150 (evaluations), the portfolio shows a mix of restorative, extraction, diagnostic, and preventive services consistent with high-throughput general dentistry clinics.

This provider is an extreme outlier statewide on many common dental codes: D2392, D7140, D1110, D0140, D0330, D2393, D2391, D0210 and numerous others all rank #1 in Ohio and are labeled "extreme outlier, far above typical state volume for this code." That consistent top-ranking across diverse codes indicates market dominance in Medicaid dental volume in Ohio and likely reflects either a large multi-site operation or very high patient throughput at one or more locations.

Specific high-cost restorative and surgical codes (for example D2740 at $4M, D3330 at $4.2M, and D3320 at $1.8M) show the provider also performs sizable volumes of complex restorative and endodontic procedures; these codes rank #1 in-state (where listed) and are described as extreme outliers, underlining the provider’s role as a major supplier of higher-acuity dental services within Medicaid. High average paid/claim amounts for those codes (e.g., $423 for D3330 and $805 for D2740 as reported) further drive revenue despite fewer claims than very high-volume preventive codes.

Volume metrics for routine preventive and diagnostic services are also enormous: codes such as D0120 (100.9K claims), D0140 (98.2K claims), D0220 (128.9K claims) and D0274 (90.6K claims) appear at very large claim counts and rank at or near the top statewide. These high-volume, low-dollar-per-claim services (for example $19 avg for D0120, $25 avg for D0140) suggest a business model focused on large patient panels and frequent encounters, consistent with mass-delivery dental operations.

Tenure on file is long: the NPI was enumerated on 2010-12-27 (~16 years ago), indicating sustained Medicaid participation over an extended period. That duration, combined with top statewide rankings, suggests the provider has established a persistent operational presence in Ohio Medicaid markets.

Operational risk and contracting implications: because the provider’s Medicaid revenue is both large ($54.1M lifetime) and highly concentrated in top codes (25.6% from the top three), payers evaluating contract terms, utilization management, or payment reforms should treat this entity as a strategically significant vendor. Any changes to reimbursement levels or prior-authorization rules for the dominant codes (notably D2392, D3330, and D7140) could materially affect the provider’s revenue and access patterns for Medicaid beneficiaries.

Medicaid: Complete Services Breakdown

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

66 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2392	Post 2 surface resin‑based composite	77,150	$60	$4.6M
D3330	N/A	9,950	$420	$4.2M
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	67,680	$60	$4.1M
D2740	N/A	5,020	$810	$4M
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	93,100	$40	$3.4M
D0330	N/A	51,330	$50	$2.5M
D0140	Limited oral evaluation – problem focused	98,240	$30	$2.5M
D2393	Resin-based composite, three surfaces, posterior	32,740	$70	$2.4M
D2391	Resin‑based composite – one surface, posterior	38,060	$60	$2.1M
D0210	Intraoral - complete series of radiographic images	39,290	$50	$2.1M

Showing 1–10 of 66

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Professional Dental Alliance, LLC — 25 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

66 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D8670	N/A	46	100	500	$290	$669K
D8080	N/A	38	40	320	$740	$474K
D8030	N/A	41	60	1,180	$70	$185.4K
D7240	N/A	9	70	220	$190	$169.6K
D2740	N/A	1	130	90	$760	$152.2K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	1	920	510	$70	$144K
D3330	N/A	1	130	40	$430	$135.8K
D2751	N/A	1	10	340	$390	$134.5K
D9243	N/A	20	40	560	$40	$114.1K
D5110	N/A	17	70	60	$420	$101.7K

Showing 1–10 of 66

Related Providers

Other providers that share a Tax Identification Number (TIN) with Professional Dental Alliance, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pda Ortho Specialty	PA	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$19M

Nearby Providers

Other providers in the same ZIP code as Professional Dental Alliance, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southwest General Health Center	OH	General Acute Care Hospital	$0	$22.9M
Continuum Care Hospice LLC	OH	Community Based Hospice Care Agency	$0	$22M
Lorraine Surgical Supply Inc	OH	Durable Medical Equipment & Medical Supplies	$0	$16.4M
Nationwide Health Management LLC	OH	Home Health Agency	$0	$13.1M
Kci Usa, Inc.	OH	Durable Medical Equipment & Medical Supplies	$0	$12.1M
Donald Martens & Sons Ambulance Service Inc.	OH	Land Ambulance	$2.6M	$9.1M
Dental Professionals Cleveland-nouneh, Inc	OH	General Practice Dentistry	$0	$9.9M
Priority Home Health Care, Inc	OH	Home Health Agency	$0	$9.1M
Dr Kmiecks Dental Health Service	OH	General Practice Dentistry	$0	$7.6M
Med Care Group Inc	OH	Internal Medicine Physician	$0	$7.4M

Professional Dental Alliance, LLC — Billing Profile & Reimbursement Data

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Professional Dental Alliance, LLC — Billing Profile & Reimbursement Data

Sign up for Professional Dental Alliance, LLC — Billing Profile & Reimbursement Data policy alerts

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