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

Why is the Medicaid comparison limited to Alabama 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. Alabama (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 Central Alabama, PC (NPI 1831328004)

Field	Value
Entity Type	Organization
Organization	Children's Dentistry Of Central Alabama, PC
Address	2425 Medical Center Pkwy
City	Selma
State	AL
ZIP	36701
Taxonomy	Pediatric Dentistry
NPI Enumerated	July 9, 2009

Payer Source	Total Paid
Medicaid	$27.3M
Medicare	$0

Key Findings

CHILDREN'S DENTISTRY OF CENTRAL ALABAMA, PC reports $27.3M in lifetime Medicaid revenue and has no Medicare billing on file, making it effectively a Medicaid‑dependent practice. Its NPI was enumerated on 2009-07-09 (~17 years ago), indicating an established presence in the state market over a multiyear period.

Revenue is highly concentrated in a small set of procedure codes: the top three Medicaid codes account for 35.9% of the provider's total Medicaid revenue. The single largest contributor is D1354 ($5.2M, 20.0% of Medicaid revenue), followed by D2930 ($2.4M, 9.1%) and D2392 ($1.8M, 6.7%), showing a few codes drive a large share of dollars.

The code mix and explicit pediatric taxonomy point to a high‑volume pediatric dental operation focused on preventive care and routine restorative services. High claim counts for preventive codes — D1208 (78.6K claims, $1.2M, 4.5%), D0120 (71.5K claims, $1.4M, 5.2%), and D1120 (56.5K claims, $1.6M, 6.0%) — indicate sustained throughput of children for prophylaxis, topical fluoride, and periodic exams.

Operative and restorative work is also a major component of the practice: D2392 (21.4K claims, $1.8M, 6.7%), D2393 (12.3K claims, $1.2M, 4.5%), and D7140 (19.8K claims, $1.1M, 4.2%) together reflect substantial composite restorations and extractions. The presence of D3220 (9K claims, $705.4K, 2.7%) and other higher‑value restorative codes reinforces that the practice provides a full spectrum of pediatric operative care, not just preventive services.

This provider is a dominant statewide competitor for many pediatric dental codes: multiple codes are listed as ranking #1 in Alabama with 100th percentile standing and labeled as “extreme outlier, far above typical state volume,” including D1354, D2392, D1120, D0120, D2393, D1208, D7140, D9230 and others. Even codes where it is not #1 — for example D2930 (rank #2 of 118, 99th percentile) and D7240 (rank #3 of 58, 96th percentile) — show volumes well above typical peers, underscoring a market leadership position within the state.

Claim volumes across many codes are very large, suggesting either multiple practice locations or exceptionally high patient throughput: examples include D1208 (78.6K claims), D0120 (71.5K claims), D1120 (56.5K claims), and D9230 (49.9K claims). Those high claim counts, combined with concentrated revenue in a few codes, indicate operations oriented to high‑frequency pediatric visits and procedures.

From a payer/contracting perspective, the absence of Medicare activity and the concentration of $27.3M in Medicaid receipts mean this provider should be treated as a Medicaid‑focused counterparty. Given that the top three Medicaid codes represent 35.9% of Medicaid revenue, any reimbursement policy changes or network decisions affecting those codes (notably D1354, D2930, D2392) could materially affect the provider's Medicaid revenue profile and operational economics.

Medicaid: Complete Services Breakdown

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

45 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1354	N/A	201,240	$30	$5.2M
D2930	N/A	22,920	$100	$2.4M
D2392	Post 2 surface resin‑based composite	21,440	$80	$1.8M
D1120	Prophylaxis–child	56,460	$30	$1.6M
D7240	N/A	7,670	$200	$1.6M
D0120	Periodic oral evaluation - established patient	71,490	$20	$1.4M
D2393	Resin-based composite, three surfaces, posterior	12,320	$100	$1.2M
D1208	Topical application of fluoride - excluding varnish	78,630	$20	$1.2M
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	19,770	$60	$1.1M
D9230	N/A	49,860	$20	$1.1M

Showing 1–10 of 45

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

Children's Dentistry Of Central Alabama, PC — 21 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

45 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D7240	N/A	3	60	610	$180	$336.5K
D7230	N/A	13	30	310	$160	$263.3K
D2930	N/A	2	120	1,240	$90	$233.9K
D3230	N/A	2	10	190	$120	$218.2K
D1354	N/A	1	90	1,190	$20	$210.5K
D9222	N/A	12	50	430	$120	$172.6K
D2392	Post 2 surface resin‑based composite	1	280	520	$70	$144.9K
D9223	N/A	13	50	520	$90	$133K
D1120	Prophylaxis–child	1	520	810	$30	$104.3K
D2391	Resin‑based composite – one surface, posterior	52	250	380	$60	$91.8K

Showing 1–10 of 45

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Selma Peditrics, P.C.	AL	Pediatrics Physician	$0	$21M
Vaughan Regional Medical Center LLC	AL	Rural Acute Care Hospital	$0	$8.1M
Dallas County Health Dept Fp Clinic	AL	Public Health or Welfare Agency	$0	$2.5M
University Of Alabama At Birmingham	AL	Family Medicine Physician	$0	$2.2M
Song Eye Center	AL	Ophthalmic Technician/Technologist	$0	$1.7M
Rural Health Medical Program, Inc.	AL	Federally Qualified Health Center (FQHC)	$0	$1.6M
Selma Family Practice Optometry, Inc.	AL	Optometrist	$0	$1.2M
Bio-medical Applications Of Alabama, Inc.	AL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1M
Bio-medical Applications Of Alabama, Inc.	AL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$931.6K
Behavioral Health Of Selma, LLC	AL	Psychologist	$0	$930.6K

Children's Dentistry Of Central Alabama, PC — Billing Profile & Reimbursement Data

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Children's Dentistry Of Central Alabama, PC — 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