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

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

Smiles 4 Kids, LLC (NPI 1811146327)

Field	Value
Entity Type	Organization
Organization	Smiles 4 Kids, LLC
Address	1411 Falls Ave E Ste 1000c
City	Twin Falls
State	ID
ZIP	83301
Taxonomy	Pediatric Dentistry
NPI Enumerated	September 9, 2008

Payer Source	Total Paid
Medicaid	$8.7M
Medicare	$0

Key Findings

This profile is effectively single‑payer: SMILES 4 KIDS, LLC shows no Medicare billing on file and $8.7M in lifetime Medicaid revenue, which indicates the provider’s financial footprint is driven entirely by Medicaid payments rather than Medicare. Analysts should treat Medicaid as the operational and contracting focus when assessing this entity.

Revenue concentration is very high: the top three Medicaid codes (D1120, D1110, D2930) account for 65.0% of the provider’s total Medicaid revenue. Specifically, D1120 accounted for $3M (35.2% of Medicaid revenue, 39.1K claims, $78 avg paid/claim), D1110 $1.6M (18.9%, 15.8K claims, $104 avg paid/claim), and D2930 $940.5K (10.9%, 14.3K claims, $66 avg paid/claim), so a handful of preventive and restorative codes drive the majority of receipts.

The code mix implies a high-volume preventive and routine restorative practice: heavy use of D1120 (Prophylaxis–child) and D1110 (Prophylaxis‑adult) points to strong emphasis on cleanings and preventive visits, while high volumes of D2392 and D2930 (the latter flagged with no description in the data) indicate substantial restorative procedure throughput as well. Given the Pediatric Dentistry taxonomy, the prominence of D1120 aligns with pediatric service lines, but the sizable D1110 volume suggests the practice either treats adults or frequently bills adult prophylaxis codes alongside pediatric services.

SMILES 4 KIDS is a dominant statewide volume leader on multiple codes. The provider ranks #1 in-state for D1120 (1 of 247, 100th percentile, classified as an "extreme outlier") and for D2392 (1 of 193, 100th percentile), ranks #2 for D1110 (2 of 318, 100th percentile, "extreme outlier") and #2 for D2930 (2 of 54, 98th percentile, "extreme outlier"); these positions indicate market-leading volumes that are far above typical state peers and suggest strong negotiating leverage and network importance for Idaho Medicaid.

There are several statistical and reporting anomalies to note: a set of codes show extraordinarily high claim counts with $0 or negligible average paid amounts (for example D0230, D0220, D0272, D1208, D1206 are all listed with very large claim volumes but $0 avg paid/claim and are labeled as extreme outliers). Additionally, D0120 reports 50.3K claims with $1 avg paid/claim (yielding $50.3K revenue) and ranks #1 of 348 providers. These patterns may reflect billing or adjudication practices (bundling, secondary claim submissions, or EDI artifacts) rather than straightforward revenue generation, and they warrant operational review during audits or contracting discussions.

Operationally, the claim volumes imply a high‑throughput clinic model: examples include 39.1K D1120 claims and 15.8K D1110 claims, which together reflect sustained patient visit volume and consistent throughput of preventive services. For payers and network planners, this scale suggests the provider is a major source of routine dental encounters within the state Medicaid program and likely a frequent referral or access point for pediatric dental care.

The provider’s tenure is long-standing: NPI enumeration date 2008-09-09 (~18 years ago) indicates an established presence in the market and suggests the observed high volumes are not transitory. Combined with $8.7M in lifetime Medicaid revenue and persistent top rankings, this points to durable provider‑payer relationships and operational stability within Idaho Medicaid.

For payer contracting and utilization management, SMILES 4 KIDS represents both concentration risk and negotiating opportunity: with 65.0% of Medicaid revenue coming from three codes and multiple top‑rank statewide positions, the practice can materially affect Medicaid preventive and restorative spend. Payers should consider close monitoring of preventive/restorative utilization trends, targeted audit triggers around high-volume or $0‑paid claim lines, and careful evaluation of network impact when setting rates or capacity expectations.

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
D1120	Prophylaxis–child	39,080	$80	$3M
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	15,780	$100	$1.6M
D2930	N/A	14,250	$70	$940.5K
D2392	Post 2 surface resin‑based composite	11,320	$80	$939.5K
D0330	N/A	6,250	$100	$630.7K
D2391	Resin‑based composite – one surface, posterior	7,340	$50	$396.3K
D0145	N/A	4,340	$50	$216.9K
D9420	N/A	1,650	$120	$196.1K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	5,250	$30	$168.1K
D0150	Comprehensive oral evaluation – new or established patient	2,690	$60	$156.1K

Showing 1–10 of 30

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Smiles 4 Kids, LLC — 12 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	2	50	750	$70	$171.2K
D1120	Prophylaxis–child	1	250	180	$60	$143K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	2	320	310	$80	$80.8K
D9420	N/A	4	40	180	$150	$80.8K
D2392	Post 2 surface resin‑based composite	1	190	280	$60	$72.9K
D2934	N/A	9	10	190	$280	$70.8K
D0210	Intraoral - complete series of radiographic images	50	120	140	$120	$66K
D0145	N/A	1	30	370	$50	$44K
D2393	Resin-based composite, three surfaces, posterior	35	70	140	$120	$41.6K
D0330	N/A	3	170	170	$50	$35.6K

Showing 1–10 of 30

Related Providers

Other providers that share a Tax Identification Number (TIN) with Smiles 4 Kids, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Trent Pryor	ID	Pediatric Dentistry	$0	$747.4K

Nearby Providers

Other providers in the same ZIP code as Smiles 4 Kids, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Homestyle Direct LLC.	ID	Home Delivered Meals	$0	$65.4M
St Luke's Clinic LLC	ID	Family Medicine Physician	$0	$39.5M
Primary Therapy Source, LLC	ID	Physical Therapist	$0	$11.7M
Wright Physical Therapy Limited Partnership	ID	Physical Therapist	$0	$8.8M
Family Health Services Corporation	ID	Federally Qualified Health Center (FQHC)	$0	$8.1M
St. Luke's Magic Valley Regional Medical Center, Ltd.	ID	General Acute Care Hospital	$0	$7.9M
Twin Falls School District #411	ID	Local Education Agency (LEA)	$0	$6.6M
Sunshine Therapy LLC	ID	Behavior Analyst	$0	$5.7M
Magic Valley Paramedics L L C	ID	Land Ambulance	$976.6K	$4.6M
Twin Falls Senior Living LLC	ID	Assisted Living Facility	$0	$4.6M

Smiles 4 Kids, LLC — Billing Profile & Reimbursement Data

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Smiles 4 Kids, LLC — 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