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.

Jonathan Nelson (NPI 1801237920)

Field	Value
Entity Type	Individual
Organization	Jonathan Nelson
Address	3700 S Russell St
City	Missoula
State	MT
ZIP	59801
Taxonomy	Dentist
NPI Enumerated	July 17, 2013

Payer Source	Total Paid
Medicaid	$316K
Medicare	$0

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	1,490	$50	$72.8K
D2392	Post 2 surface resin‑based composite	380	$120	$46.4K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	2,370	$20	$45K
D0120	Periodic oral evaluation - established patient	1,860	$20	$42.8K
D4910	Periodontal maintenance procedures	640	$70	$41.5K
D0274	N/A	950	$30	$31.4K
D2391	Resin‑based composite – one surface, posterior	230	$70	$14.8K
D0150	Comprehensive oral evaluation – new or established patient	230	$30	$7.2K
D2393	Resin-based composite, three surfaces, posterior	30	$170	$5.8K
D0230	Intraoral - periapical each additional radiographic image	420	$10	$3.3K

Showing 1–10 of 15

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

Jonathan Nelson — 0 of 15 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2392	Post 2 surface resin‑based composite	61	130	310	$120	$173.4K
D2393	Resin-based composite, three surfaces, posterior	41	60	70	$160	$59.6K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	45	260	340	$20	$54.4K
D2391	Resin‑based composite – one surface, posterior	47	110	170	$60	$50.7K
D0120	Periodic oral evaluation - established patient	57	300	410	$20	$50.7K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	51	270	310	$40	$44K
D0330	N/A	121	150	210	$50	$35.7K
D0274	N/A	49	210	200	$30	$23.2K
D1320	N/A	29	30	140	$30	$20.7K
D0150	Comprehensive oral evaluation – new or established patient	101	190	270	$30	$20.3K

Showing 1–10 of 15

Nearby Providers

Other providers in the same ZIP code as Jonathan Nelson, 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
Children's Dentistry Of The Rockies	MT	Pediatric Dentistry	$0	$10.1M
Missoula Pediatric Dentistry PC	MT	Pediatric Dentistry	$0	$9.3M

Jonathan Nelson — Billing Profile & Reimbursement Data

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Jonathan Nelson — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References