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

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

Peninsula Community Health Services (NPI 1740630128)

Field	Value
Entity Type	Organization
Organization	Peninsula Community Health Services
Address	616 6th St
City	Bremerton
State	WA
ZIP	98337
Taxonomy	General Practice Dentistry
NPI Enumerated	June 16, 2016

Payer Source	Total Paid
Medicaid	$41.5M
Medicare	$0

Key Findings

PENINSULA COMMUNITY HEALTH SERVICES reports no Medicare billing on file and is effectively a single-payer Medicaid provider in this dataset, with Total Medicaid revenue of $41.5M. The absence of Medicare revenue indicates the organization’s patient mix and reimbursement exposure are concentrated in Medicaid rather than traditional fee-for-service Medicare populations.

Revenue concentration is extremely high: the precomputed top-3 Medicaid codes account for 81.7% of the provider’s total Medicaid revenue, indicating a business model highly dependent on a narrow set of service lines. T1015 alone generates $31.7M (76.4% of Medicaid revenue), making clinic encounter billing the dominant revenue driver for the organization.

The code mix and top revenue drivers indicate a primary focus on general dentistry and high-volume clinic encounters. Large volumes of T1015 (Clinic visit/encounter, all-inclusive) together with frequent evaluation and preventive codes such as D0120, D0150, D1206, D1110 and D1120 suggest the provider operates as a high-throughput community dental clinic offering routine exams, cleanings, topical fluoride, and basic restorative procedures.

Competitive standing within Washington Medicaid: PENINSULA ranks very highly on many codes, demonstrating a dominant in-state presence for several services. For example, T1015 ranks #7 of 652 providers (99th percentile) and D0220 ranks #7 of 760 (99th percentile), while multiple other codes are in the 97th–100th percentiles; several are labeled “extreme outlier” or “notably above typical state volume,” indicating volumes far above most peers for those services.

Patient care mix appears weighted toward preventive and basic restorative pediatric and adult dental services based on high volumes of D1206 (Topical Fluoride), D1110/D1120 (adult/child prophylaxis), and D2391/D2392 (posterior composite restorations). The combination of high prophylaxis and fluoride applications with extensive radiography codes (D0220, D0230, D0274) suggests standardized intake, diagnostic imaging, and routine treatment workflows consistent with community health dental operations.

Several codes are statistical outliers in-state, highlighting unusually concentrated utilization patterns: D0330, D0140, D0230 and D1999 are described as “extreme outlier” or “far above typical state volume,” and the provider ranks in top single-digit positions for these codes. These outlier designations point to operational emphasis on specific imaging, problem-focused evaluations and other bundled services that drive disproportionate claim volumes relative to peers.

The provider’s NPI was enumerated on 2016-06-16, meaning it has been registered for ~10 years. That tenure supports the idea that the high Medicaid volumes and established code mix reflect an operational pattern developed over multiple years rather than a very recent change in billing behavior.

Despite very large volumes on a few codes, many restorative and specialty codes remain modest contributors to revenue (individual codes outside the top three generally represent less than 3% of Medicaid revenue each). This suggests the organization scales by high encounter throughput and routine services rather than by high-dollar specialty procedures.

Medicaid: Complete Services Breakdown

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

40 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	176,830	$180	$31.7M
D0120	Periodic oral evaluation - established patient	43,450	$30	$1.1M
D2392	Post 2 surface resin‑based composite	17,360	$60	$1M
D0330	N/A	29,420	$30	$971K
D0150	Comprehensive oral evaluation – new or established patient	28,290	$30	$933.5K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	34,790	$20	$660.9K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	15,260	$40	$656K
D0220	Intraoral - periapical first radiographic image	80,930	$10	$647.4K
D0140	Limited oral evaluation – problem focused	26,800	$20	$616.4K
D2391	Resin‑based composite – one surface, posterior	12,790	$50	$613.9K

Showing 1–10 of 40

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Washington Distribution

Peninsula Community Health Services — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

40 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	7	650	4,110	$250	$4.9M
D2392	Post 2 surface resin‑based composite	13	540	990	$60	$188.6K
D2150	Amalgam - two surfaces, primary or permanent	47	60	310	$50	$137.2K
D0120	Periodic oral evaluation - established patient	24	920	690	$20	$131.3K
D2391	Resin‑based composite – one surface, posterior	14	480	670	$50	$119.5K
D1120	Prophylaxis–child	55	730	690	$20	$112.8K
D1351	Sealant - per tooth	113	400	1,120	$20	$103.9K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	30	390	640	$50	$98.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	31	730	730	$20	$98.5K
D2140	Amalgam - one surface, primary or permanent	40	40	290	$40	$95.2K

Showing 1–10 of 40

Related Providers

Other providers that share a Tax Identification Number (TIN) with Peninsula Community Health Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peninsula Community Health Services	WA	Federally Qualified Health Center (FQHC)	$0	$3.7M
Peninsula Community Health Services	WA	Federally Qualified Health Center (FQHC)	$0	$3.6M
Kristen Sylvester	WA	Family Nurse Practitioner	$32.9K	$0
Adriana Taseva	WA	Family Medicine Physician	$31.5K	$0
Reyne Yamane	WA	Family Nurse Practitioner	$10.1K	$0

Nearby Providers

Other providers in the same ZIP code as Peninsula Community Health Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
City Of Bremerton	WA	Land Ambulance	$150.9K	$3.3M

Peninsula Community Health Services — Billing Profile & Reimbursement Data

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Peninsula Community Health Services — 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