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 U.S. Virgin Islands for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to U.S. Virgin Islands 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. U.S. Virgin Islands (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.

Braces Plus PC (NPI 1740741073)

Field	Value
Entity Type	Organization
Organization	Braces Plus PC
Address	1916 Ninth St
City	St Thomas
State	VI
ZIP	00802
Taxonomy	Dental Clinic/Center
NPI Enumerated	March 28, 2019

Payer Source	Total Paid
Medicaid	$470.8K
Medicare	$0

Key Findings

This profile shows no Medicare billing on file and $470.8K in lifetime Medicaid revenue, indicating the provider’s activity in the available claims data is effectively single-payer (Medicaid) rather than split between Medicare and Medicaid. Analysts should treat comparisons that assume Medicare participation as not applicable for this entity.

Revenue concentration is high within a small set of dental codes: the precomputed top three Medicaid codes (D0330, D2392, D0274) together account for 53.4% of the provider’s Medicaid revenue, with individual shares recorded as 21.7% for D0330, 16.3% for D2392, and 15.5% for D0274. That concentration implies these specific procedures are the primary drivers of the provider’s Medicaid-facing revenue.

The provider’s code mix and taxonomy (Dental Clinic/Center) point to a practice focused on restorative and diagnostic services: D2392 (post 2 surface resin‑based composite) is a top revenue contributor, and D0150 (comprehensive oral evaluation) also figures prominently. High counts for D0330 (709 claims) and D0150 (605 claims) suggest steady patient throughput of routine diagnostics and comprehensive exams, while multiple resin-based restoration codes (D2391, D2393) support a restorative-service emphasis.

Competitive standing across in-state peers is modest rather than dominant. Top codes mostly rank in the lower-to-middle range among state peers (for example, D0330 ranks #6 of 8, 29th percentile; D2392 ranks #5 of 7, 33th percentile; D0274 ranks #6 of 9, 38th percentile), indicating typical or unremarkable volume for those services rather than market leadership.

There are a few services where this provider appears as a unique or uncommon state-level biller: D2752 appears as #1 of 1 providers in-state (0th percentile; no state peer volume comparison available) and contributes $31.5K (6.7% of Medicaid revenue) with a high average paid/claim of $984. This pattern suggests the practice occasionally delivers higher-cost restorative/prosthetic procedures that other in-state Medicaid billers do not commonly report.

Several commonly billed dental items contribute only marginal revenue here, which may reflect patient mix or coding patterns: D0220, D0350, D0120, and D1110 each account for 0.6% or less of Medicaid revenue and rank at or near the low end among peers (several listed at 0th percentile), signaling limited use of isolated radiographs, certain diagnostic codes, periodic evaluations, and adult prophylaxis in this Medicaid caseload.

The provider’s tenure is relatively recent in NPI terms: enumerated on 2019-03-28 (~7 years ago). Given modest statewide rankings on core procedures and a Medicaid-only billing footprint, the practice appears to be an established but not dominant Medicaid dental clinic with room to expand either volume or service breadth within the state.

Beyond the major restorative and evaluation lines, the top-10 code list includes several other resin‑based composite and restorative codes (D2391, D2393, D2950) and limited use of periodontal/cleaning codes, reinforcing that revenue is driven by restorative dentistry rather than preventive adult hygiene for this Medicaid population.

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D0330	N/A	710	$140	$102.1K
D2392	Post 2 surface resin‑based composite	300	$260	$76.7K
D0274	N/A	510	$140	$72.8K
D0150	Comprehensive oral evaluation – new or established patient	610	$100	$62.9K
D0140	Limited oral evaluation – problem focused	470	$90	$41.7K
D2950	N/A	110	$310	$33.2K
D2391	Resin‑based composite – one surface, posterior	180	$180	$31.5K
D2752	N/A	30	$980	$31.5K
D2393	Resin-based composite, three surfaces, posterior	50	$240	$11.7K
D0220	Intraoral - periapical first radiographic image	110	$30	$2.6K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. U.S. Virgin Islands Distribution

Braces Plus PC — 0 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — U.S. Virgin Islands

Full comparison — all codes billed, vs. U.S. Virgin Islands median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2392	Post 2 surface resin‑based composite	5	10	520	$230	$376.2K
D2950	N/A	4	10	560	$300	$344.4K
D2391	Resin‑based composite – one surface, posterior	6	10	190	$180	$232.4K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	8	10	1,090	$80	$167.9K
D0330	N/A	6	10	1,190	$100	$161.7K
D0140	Limited oral evaluation – problem focused	6	10	2,520	$70	$156K
D0150	Comprehensive oral evaluation – new or established patient	6	10	610	$90	$153.7K
D2393	Resin-based composite, three surfaces, posterior	4	10	50	$260	$69.2K
D0274	N/A	6	10	830	$50	$69.1K
D0120	Periodic oral evaluation - established patient	10	10	630	$60	$69K

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as Braces Plus PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Duanne Jones	VI	Public Health Dentistry	$0	$33.2M
Vi Government Hospital And Health Facilities Corp	VI	General Acute Care Hospital	$0	$23.6M
The St Thomas East End Medical Center Corporation	VI	Federal Public Health Clinic/Center	$0	$12.8M
Aac-air Ambulance Caribbean Inc.	VI	Air Ambulance	$2M	$8.6M
Vi Relocation Services And Rentals LLC	VI	Land Ambulance	$0	$6.8M
Alicia Prentice	VI	Home Health Aide	$0	$3.9M
Stretcher Plus, LLC	VI	Non-emergency Medical Transport (VAN)	$0	$2.8M
Cog Restore, LLC	VI	Rehabilitation Clinic/Center	$0	$2.1M
Dept Of Health, Govt Of Vi Ems St Thomas	VI	Land Ambulance	$0	$1.5M
Vi Oral Surgery, Inc	VI	Oral and Maxillofacial Surgery (Dentist)	$0	$1.4M

Braces Plus PC — Billing Profile & Reimbursement Data

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Braces Plus 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

Nearby Providers

Frequently Asked Questions

References