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

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

D4c Of Texas PLLC (NPI 1790370542)

Field	Value
Entity Type	Organization
Organization	D4c Of Texas PLLC
Address	14058 Bee Cave Pkwy Ste B
City	Austin
State	TX
ZIP	78738
Taxonomy	Pediatric Dentistry
NPI Enumerated	March 3, 2021

Payer Source	Total Paid
Medicaid	$75.3M
Medicare	$0

Key Findings

Provider is effectively a Medicaid-focused operation: Medicare billing shows "none below" (no Medicare billing on file) while lifetime Medicaid revenue is $75.3M, indicating this entity is essentially single-payer (Medicaid) in scale and exposure. Analysts should treat Medicaid policy and rate changes as primary revenue risk drivers.

Revenue is concentrated in a small set of codes: the precomputed top three Medicaid codes (D2930, D0145, D1351) together account for 34.1% of the provider's total Medicaid revenue. Individually these codes generate $11.7M (D2930, 15.8%), $7M (D0145, 9.5%), and $6.5M (D1351, 8.8%), making them key levers for any utilization or reimbursement shift.

The code mix and taxonomy (Pediatric Dentistry) point to a high-volume pediatric preventive model: D1351 (Sealant - per tooth) appears as a top revenue driver alongside high volumes for D1120 (Prophylaxis–child, 175.7K claims, $6M) and D1206 (Topical Fluoride Treatment, 214.1K claims, $3M). This combination of sealants, prophylaxis, topical fluoride, and frequent periodic exams suggests operational emphasis on routine preventive services for children.

Alongside preventive care, the practice also reports meaningful restorative and surgical activity, indicating broader clinical capability beyond simple prevention. Examples include D2392 ($5.8M), D2391 ($2.9M), D3220 ($2.7M), D7140 ($951.8K), and D3330 ($935.2K); these revenues demonstrate capacity to deliver multi-surface restorations, extractions and higher-cost procedures.

Competitive standing in Texas is dominant for many codes: the provider ranks #1 statewide on multiple high-volume items (for example D0145 ranks #1 of 2706 providers in-state (100th percentile; extreme outlier), D1351 ranks #1 of 2820 providers (100th percentile; extreme outlier), and D0120 ranks #1 of 5000 providers (100th percentile; extreme outlier)). These rank/percentile positions indicate the provider is a major outlier and a leading in-state supplier for core pediatric dental services.

Operational throughput is extraordinarily high on several imaging and preventive codes, which implies very large patient volume and visit frequency: D0230 shows 288.7K claims, D0220 249.2K claims, D1351 260K claims, and D0120 209.6K claims. Such claim counts are far above typical peer volumes and are consistent with the "extreme outlier" labels attached to many of these codes.

Not all high-revenue items are identical in comparative intensity: many top codes are labeled "extreme outlier" (100th percentile) across the state, but a few codes are described as "notably above typical" or "typical, unremarkable" (for example D3330 is 97th percentile, "notably above typical", while D7240 is 94th percentile, "typical, unremarkable"). This suggests the provider is unusually concentrated on a defined set of pediatric services while other higher-cost procedures are present but less dominant.

NPI tenure is relatively recent: the NPI was enumerated on 2021-03-03 (~5 years ago), and the lifetime billing record already shows $75.3M in Medicaid revenue. Rapid scaling to the current Medicaid revenue level in ~5 years may be relevant for network contracting, capacity planning, and competitive analysis given the provider's outsized in-state presence.

Medicaid: Complete Services Breakdown

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

53 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2930	N/A	88,390	$130	$11.7M
D0145	N/A	53,370	$130	$7M
D1351	Sealant - per tooth	259,950	$30	$6.5M
D1120	Prophylaxis–child	175,650	$30	$6M
D2392	Post 2 surface resin‑based composite	62,040	$90	$5.8M
D0120	Periodic oral evaluation - established patient	209,560	$30	$5.7M
D0272	N/A	156,320	$20	$3.1M
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	214,140	$10	$3M
D0230	Intraoral - periapical each additional radiographic image	288,710	$10	$2.9M
D2391	Resin‑based composite – one surface, posterior	39,710	$70	$2.9M

Showing 1–10 of 53

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

D4c Of Texas PLLC — 24 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

53 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	2	1,000	460	$140	$261.5K
D7240	N/A	15	230	260	$260	$247.2K
D3330	N/A	2	30	60	$560	$234.4K
D2392	Post 2 surface resin‑based composite	1	2,600	490	$90	$164.2K
D2934	N/A	2	120	200	$140	$114.5K
D9223	N/A	4	140	350	$60	$112.8K
D0145	N/A	1	2,710	230	$130	$110.1K
D1351	Sealant - per tooth	1	2,820	1,220	$20	$93K
D2391	Resin‑based composite – one surface, posterior	1	2,040	320	$70	$88.8K
D7230	N/A	29	60	100	$160	$75.2K

Showing 1–10 of 53

Nearby Providers

Other providers in the same ZIP code as D4c Of Texas PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Texas Home Modification Services LLC	TX	Home Modifications Contractor	$0	$27.9M
Aspira Labs, Inc.	TX	Clinical Medical Laboratory	$1.4M	$1.2M
Lakeway Ambulatory Surgery Center, LLC	TX	Ambulatory Surgical Clinic/Center	$1.3M	$0
Falconhead Surgery Center LLC	TX	Ambulatory Surgical Clinic/Center	$1.2M	$0
Taustin Laboratories	TX	Clinical Medical Laboratory	$804.8K	$0
Christopher Vije	TX	Interventional Pain Medicine Physician	$526.4K	$0
Pavan Karnati	TX	Cardiovascular Disease Physician	$322.1K	$0
Naresh Desireddi	TX	Urology Physician	$255.6K	$0
Thomas Baldacchino	TX	Cardiovascular Disease Physician	$169.9K	$0
Jeremy Jones	TX	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$156.2K	$0

D4c Of Texas PLLC — Billing Profile & Reimbursement Data

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D4c Of Texas PLLC — 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