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

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

Roy E. Paulson Jr PC (NPI 1750584173)

Field	Value
Entity Type	Organization
Organization	Roy E. Paulson Jr PC
Address	102 N. Kenwood St.
City	Casper
State	WY
ZIP	82601
Taxonomy	Pediatric Dentistry
NPI Enumerated	June 6, 2007

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid practice: Medicare revenue is none on file while lifetime Medicaid revenue is $1.8M, indicating the provider’s entire reported federal billing footprint is concentrated in Medicaid. The NPI was enumerated 2007-06-06 (~19 years ago), so this profile represents an established practice with a long active billing history in the state.

Revenue concentration is significant at the code level: the precomputed top three Medicaid codes together account for 37.4% of the provider’s total Medicaid revenue. Those top three codes are D2930 ($291.5K, 16.5%), D1120 ($188.6K, 10.7%), and D1206 ($180.1K, 10.2%), showing a heavy reliance on a small set of procedures for over one-third of Medicaid income.

The clinical and business mix aligns with Pediatric Dentistry: high volumes of pediatric preventive services appear central to the operation, with D1120 showing 5.9K claims and D1206 5.6K claims, and sealants (D1351) at 2.6K claims. These are lower-paid, high-frequency services (e.g., D1120 avg paid/claim $32; D1206 avg paid/claim $32) which suggests a workflow optimized for high-throughput preventive pediatric care.

The practice also provides a meaningful volume of restorative and surgical work alongside prevention: D2930 ($138 avg paid/claim; 2.1K claims, $291.5K revenue) and D3220 ($143.6K revenue, 1.7K claims) represent higher-reimbursement items in the mix, while extractions (D7140, $95.9K) and restorations (D2150, D2391) are material contributors. This blend indicates a full-service pediatric dental clinic that combines routine prevention with operative procedures.

Competitive standing across in-state peers is mixed but notable in specific codes: the provider ranks #1 of 5 for D3220 and #1 of 3 for D0240 (both 100th percentile and identified as notably above typical state volume for those codes), signaling dominance for those particular procedure lines in-state. At the same time, several high-volume preventive codes are described as typical or unremarkable despite being in high percentiles (for example, D1120 ranks #6 of 95 and is labeled typical, unremarkable volume), which suggests the provider’s footprint is especially concentrated in a few procedure niches rather than uniformly dominant across all pediatric codes.

Several codes are flagged as statistical outliers relative to state peers: D3220 and D0240 are both 100th percentile and described as notably above typical state volume, and D1208 and D1330 are also described as notably above typical. These elevated positions for specific codes imply targeted strengths or specialty procedural capacity that distinguish the provider from many in-state peers for those services.

From a contracting and utilization perspective, the practice’s financial profile is driven by large claim counts on low-unit-price preventive services combined with a smaller number of higher-paid procedures; examples include D1120 (5.9K claims, $32 avg paid/claim) and D2930 (2.1K claims, $138 avg paid/claim). For payers evaluating network adequacy or pediatric access, this pattern signals strong capacity to deliver high-volume preventive care to Medicaid populations while also handling more resource-intensive pediatric procedures.

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
D2930	N/A	2,110	$140	$291.5K
D1120	Prophylaxis–child	5,890	$30	$188.6K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	5,630	$30	$180.1K
D0120	Periodic oral evaluation - established patient	5,700	$30	$171K
D3220	N/A	1,710	$80	$143.6K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	1,390	$70	$95.9K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	1,910	$50	$85.7K
D1351	Sealant - per tooth	2,580	$30	$72.3K
D0272	N/A	3,030	$20	$63.7K
D9230	N/A	2,730	$20	$60K

Showing 1–10 of 30

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wyoming Distribution

Roy E. Paulson Jr PC — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	2	10	810	$130	$141.9K
D2150	Amalgam - two surfaces, primary or permanent	2	10	150	$100	$140K
D8670	N/A	8	10	370	$130	$90.6K
D2392	Post 2 surface resin‑based composite	12	30	230	$90	$87.4K
D1351	Sealant - per tooth	8	30	200	$30	$64.6K
D2391	Resin‑based composite – one surface, posterior	7	20	140	$70	$56.9K
D3220	N/A	1	10	300	$80	$52.3K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	7	100	130	$30	$46.4K
D3120	N/A	2	10	1,810	$30	$46K
D9248	N/A	2	10	270	$100	$40.8K

Showing 1–10 of 30

Related Providers

Other providers that share a Tax Identification Number (TIN) with Roy E. Paulson Jr PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Roy Paulson	WY	Pediatric Dentistry	$0	$12.7K

Nearby Providers

Other providers in the same ZIP code as Roy E. Paulson Jr PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Wyoming	WY	Federally Qualified Health Center (FQHC)	$0	$14.8M
Bear Country Home Healthcare	WY	Home Health Agency	$0	$7.8M
Wyoming Independent Living Rehabilitation, Inc.	WY	Case Management Agency	$0	$4.7M
Wyoming Medical Center Inc	WY	General Acute Care Hospital	$0	$4.4M
Douglas Holmes	WY	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Emergency Medical Physicians PC	WY	Emergency Medicine Physician	$0	$4.1M
Acm Therapy Group LLC	WY	Occupational Therapist	$0	$3.6M
Emg Casper Pp LLC	WY	Assisted Living Facility	$0	$3.5M
Renewed Hope Foundation, Inc.	WY	Physical Therapist	$0	$2.6M
Optimal Physical Therapy, LLC	WY	Physical Therapy Clinic/Center	$0	$2.5M

Roy E. Paulson Jr PC — Billing Profile & Reimbursement Data

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Roy E. Paulson Jr 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