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

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

Children's Dentistry Of The Rockies (NPI 1790939932)

Field	Value
Entity Type	Organization
Organization	Children's Dentistry Of The Rockies
Address	1009 S Reserve St
City	Missoula
State	MT
ZIP	59801
Taxonomy	Pediatric Dentistry
NPI Enumerated	November 14, 2008

Payer Source	Total Paid
Medicaid	$10.1M
Medicare	$0

Key Findings

This profile is effectively single‑payer at scale: the provider reports no Medicare billing on file and $10.1M in lifetime Medicaid revenue, indicating its commercial footprint in Medicare is negligible while its operations are concentrated in Medicaid. CHILDREN'S DENTISTRY OF THE ROCKIES has an NPI enumerated 2008-11-14 (~18 years ago), consistent with an established practice tenure in the market.

Revenue concentration is substantial in a small set of services: the precomputed top 3 Medicaid codes by revenue account for 37.5% of this provider's total Medicaid revenue. Those top drivers are D0120 ($1.3M, 44.7K claims, 13.0%), D2392 ($1.3M, 9.7K claims, 12.9%), and D1120 ($1.2M, 33.1K claims, 11.6%), showing a heavy reliance on a mix of exam and restorative codes.

The code mix and volumes point to a high‑throughput pediatric dental model focused on prevention and routine restorative care: large counts for D0120 (44.7K claims) and D1120 (33.1K claims) alongside major volumes for restorative D2392 (9.7K claims) and sealant D1351 (13.1K claims) indicate recurring periodic evaluations, prophylaxis, topical fluoride work, and composite restorations form the operational core. Average paid/claim values are modest (for example $29 for D0120, $35 for D1120, $21 for D1206), which is consistent with Medicaid reimbursement levels and a high‑volume clinic or multi‑chair practice model.

CHILDREN'S DENTISTRY is a statewide leader on multiple preventive codes: it ranks #2 of 298 for D0120 (100th percentile, labeled an "extreme outlier"), #4 of 180 for D1120 (98th percentile, "extreme outlier"), and #4 of 259 for D1206 (99th percentile, "extreme outlier"). These rank and percentile placements indicate the provider is a dominant participant in Montana for routine pediatric evaluations and fluoride therapy relative to in‑state peers.

Several codes show unusually high in‑state standing beyond core pediatric preventive services. The provider is #2 of 270 for D1110 (adult prophylaxis, 11.6K claims, $49 avg paid/claim; 100th percentile, "extreme outlier") and #1 of 68 for D1208 (11.5K claims, $18 avg paid/claim; 100th percentile, "extreme outlier"), suggesting either a broader age mix in patient population or an operational emphasis that includes substantial adult preventive billing alongside pediatric care. This pattern warrants attention when comparing payer mix or assessing clinic patient demographics.

The practice delivers a breadth of operative services in addition to prevention: notable Medicaid revenue and utilization for restorative codes D2392 ($1.3M, 9.7K claims), D2393 ($234.6K, 1.3K claims), and D2391 ($111.7K, 1.6K claims), plus D7140 extractions ($293.1K, 3.8K claims), indicate capacity for multi‑surface composite work and extractions consistent with comprehensive pediatric dentistry rather than a prevention‑only model. These restorative and surgical volumes support the view that the clinic handles ongoing operative caseflow in addition to high preventive throughput.

Operationally, the provider’s high claim volumes with relatively low per‑claim payments—examples include D0120 at 44.7K claims ($29 avg paid/claim), D1206 at 34.9K claims ($21 avg paid/claim), and D1120 at 33.1K claims ($35 avg paid/claim)—are consistent with a scale‑based Medicaid practice. Combined with top‑percentile ranks on multiple codes, this suggests the organization relies on throughput and a broad service mix (preventive, restorative, radiographs) to generate $10.1M in Medicaid revenue rather than high unit prices.

Medicaid: Complete Services Breakdown

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

32 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D0120	Periodic oral evaluation - established patient	44,710	$30	$1.3M
D2392	Post 2 surface resin‑based composite	9,730	$130	$1.3M
D1120	Prophylaxis–child	33,070	$40	$1.2M
D2930	N/A	7,670	$130	$1M
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	34,920	$20	$733.3K
D1310	N/A	16,480	$40	$642.7K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	11,600	$50	$568.3K
D1351	Sealant - per tooth	13,120	$30	$380.5K
D1330	N/A	16,490	$20	$379.2K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	3,810	$80	$293.1K

Showing 1–10 of 32

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Children's Dentistry Of The Rockies — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

32 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	5	20	2,090	$120	$493.4K
D2392	Post 2 surface resin‑based composite	5	130	310	$120	$173.4K
D2929	N/A	4	10	400	$190	$126.3K
D1310	N/A	3	50	520	$40	$119.6K
D1351	Sealant - per tooth	6	60	590	$30	$101.4K
D1120	Prophylaxis–child	4	180	200	$30	$88.4K
D1330	N/A	3	60	340	$20	$65.6K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	7	80	290	$50	$59.8K
D2393	Resin-based composite, three surfaces, posterior	5	60	70	$160	$59.6K
D9230	N/A	3	50	250	$30	$55.8K

Showing 1–10 of 32

Nearby Providers

Other providers in the same ZIP code as Children's Dentistry Of The Rockies, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Western Montana Mental Health Center	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$87.8M
Opportunity Resources Inc	MT	Developmentally Disabled Services Day Training Agency	$0	$48.5M
Missoula Developmental Service Corp	MT	Non-emergency Medical Transport (VAN)	$0	$33.6M
Express Personnel Services	MT	Nursing Care Agency	$0	$20.4M
3 Rivers Mental Health Solutions LLC	MT	Community/Behavioral Health Agency	$0	$16.7M
Missoula County Public Schools	MT	Local Education Agency (LEA)	$0	$16.3M
Meadowlark Home Care LLC	MT	Home Health Agency	$0	$12.9M
Client Dedicated Services, Inc	MT	Home Health Agency	$0	$10.6M
Missoula Pediatric Dentistry PC	MT	Pediatric Dentistry	$0	$9.3M
Missoula Oral Surgery	MT	Oral and Maxillofacial Surgery Clinic/Center	$0	$8M

Children's Dentistry Of The Rockies — Billing Profile & Reimbursement Data

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Children's Dentistry Of The Rockies — 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