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.

Carl Hackney (NPI 1790897080)

Field	Value
Entity Type	Individual
Organization	Carl Hackney
Address	Riverside Drive
City	Grundy
State	VI
ZIP	24614
Taxonomy	Dentist
NPI Enumerated	August 31, 2006

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-only biller: there is no Medicare billing on file while lifetime Medicaid revenue totals $1.1M, so payer mix is highly concentrated in Medicaid rather than split between Medicare and Medicaid. Analysts should treat CARL HACKNEY as a single-payer Medicaid practice for competitive and utilization comparisons.

Revenue concentration is notable: the precomputed top-3 Medicaid codes account for 44.1% of the provider's total Medicaid revenue, indicating that a minority of procedure types drive nearly half of all Medicaid receipts. This suggests focused service lines around a few high-volume or higher-paid procedures.

Clinical/service-line profile is dental-generalist with strong emphasis on extractions and preventive care: the single largest code by revenue is D7140 (extraction, erupted tooth) with $250.9K (23.3% of Medicaid revenue), followed by D1110 (adult prophylaxis) and D9630; the mix indicates a practice delivering routine cleanings and a high volume of simple tooth extractions.

Competitive standing for key procedures shows locally elevated activity: D7140 ranks #2 of 9 in-state and is described as notably above typical state volume, and D0220 ranks #1 of 9 and is 100th percentile, both implying this provider is a major state-level performer on extractions and periapical imaging relative to peers. These rank/percentile signals point to stronger-than-typical throughput for select services.

Several codes are extreme or unique in the state peer set: D9630, D2335, D2394, D9994 and a few others are listed as rank #1 with no state peer volume comparison available (0th percentile in the dataset), indicating services or billing patterns with no direct in-state comparators in the source data; these entries warrant attention when benchmarking service mix.

Service breadth includes diagnostic imaging and evaluations: multiple radiographic and exam codes appear in the top billing list (D0210, D0220, D0230, D0230 and D0120/D0150), showing the practice provides comprehensive intraoral imaging and both comprehensive and periodic evaluations alongside operative and preventive procedures. This combination is consistent with a general dental practice offering full patient visits.

Tenure is long: the NPI was enumerated on 2006-08-31 (~20 years ago), suggesting sustained presence in the market and that the observed billing patterns reflect established practice behavior rather than short-term or transient activity.

Medicaid: Complete Services Breakdown

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	5,450	$50	$250.9K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	3,250	$40	$120.4K
D9630	N/A	6,960	$20	$104.4K
D0274	N/A	3,350	$20	$66.9K
D0150	Comprehensive oral evaluation – new or established patient	2,960	$20	$62.2K
D0140	Limited oral evaluation – problem focused	3,690	$20	$55.3K
D0210	Intraoral - complete series of radiographic images	2,100	$30	$54.6K
D0220	Intraoral - periapical first radiographic image	7,050	$10	$49.3K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	560	$70	$39.3K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	1,970	$20	$35.4K

Showing 1–10 of 25

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

Carl Hackney — 3 of 25 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

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2392	Post 2 surface resin‑based composite	4	10	520	$230	$376.2K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	3	10	1,020	$270	$320.4K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	2	10	1,120	$160	$299.5K
D2391	Resin‑based composite – one surface, posterior	4	10	190	$180	$232.4K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	3	10	1,090	$80	$167.9K
D0330	N/A	5	10	1,190	$100	$161.7K
D0140	Limited oral evaluation – problem focused	2	10	2,520	$70	$156K
D0210	Intraoral - complete series of radiographic images	2	10	1,080	$100	$155.7K
D0150	Comprehensive oral evaluation – new or established patient	3	10	610	$90	$153.7K
D9630	N/A	1	10	6,960	$10	$102.5K

Showing 1–10 of 25

Nearby Providers

Other providers in the same ZIP code as Carl Hackney, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Buchanan General Hospital, Inc	VA	General Acute Care Hospital	$0	$11.2M
Madhava Pally	VA	Cardiovascular Disease Physician	$113.1K	$0
Susan Mullooly	VA	Emergency Medicine Physician	$70.6K	$0
Jenny Cole	VA	Family Nurse Practitioner	$24.7K	$0
Tina Williams	VA	Family Nurse Practitioner	$12.5K	$0

Carl Hackney — Billing Profile & Reimbursement Data

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Carl Hackney — 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