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

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

Legacy Dental, P.C. (NPI 1811283302)

Field	Value
Entity Type	Organization
Organization	Legacy Dental, P.C.
Address	4409 Sw 9th St
City	Des Moines
State	IA
ZIP	50315
Taxonomy	Oral and Maxillofacial Surgery Clinic/Center
NPI Enumerated	June 22, 2011

Payer Source	Total Paid
Medicaid	$4.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D7240	N/A	4,160	$200	$847.8K
D9243	N/A	10,510	$70	$735.4K
D7230	N/A	3,690	$180	$671.6K
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…	6,130	$100	$600.3K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	11,290	$50	$564.3K
D9239	N/A	5,480	$80	$416.3K
D9310	N/A	6,870	$30	$178.5K
D7220	N/A	750	$140	$105.5K
D0330	N/A	1,850	$40	$72.1K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Legacy Dental, P.C. — 7 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D9243	N/A	1	10	1,340	$70	$239.6K
D7240	N/A	2	20	180	$220	$228.7K
D7230	N/A	1	10	300	$190	$169.9K
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…	4	40	310	$100	$162.7K
D9239	N/A	1	10	720	$80	$134.7K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	6	170	330	$50	$88.3K
D7220	N/A	1	10	310	$140	$48.5K
D9310	N/A	1	30	350	$30	$32.2K
D0330	N/A	33	270	170	$20	$16.1K

Nearby Providers

Other providers in the same ZIP code as Legacy Dental, P.C., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Clinics, Inc.	IA	Primary Care Clinic/Center	$0	$2.8M
Mercyone Central Iowa Urgent Care	IA	Clinic/Center	$0	$1.1M
Garner Family Dental	IA	General Practice Dentistry	$0	$892.1K
Hy-vee Inc	IA	Community/Retail Pharmacy	$162.4K	$188.6K
Nadia Clark	IA	Family Nurse Practitioner	$202.4K	$0
David Scott	IA	Optometrist	$66.8K	$11.3K
Paul Snowdy	IA	Physician Assistant	$69.8K	$0
Sue Forkah-musoro	IA	Adult Health Nurse Practitioner	$65.3K	$0
Joseph Johns	IA	Physical Therapist	$45K	$0
Anne Hytrek	IA	Registered Dietitian	$5.5K	$0

Legacy Dental, P.C. — Billing Profile & Reimbursement Data

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Legacy Dental, P.C. — Billing Profile & Reimbursement Data

Sign up for Legacy Dental, P.C. — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References