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    OpenPayerNPI Medicare & MedicaidIdental LLC
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    Idental LLC — Billing Profile & Reimbursement Data

    NPI 1861867947 · Mt Pleasant, WI · Dentist

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    Idental LLC is a dentist provider located in Mt Pleasant, Wisconsin. This profile covers 0 Medicare and 45 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    Provider details (source: NPPES NPI Registry)

    Table of contents

    Progress1 / 7

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    • Billing CodesCPT, HCPCS, DRG & more
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    FieldValue
    Entity TypeOrganization
    OrganizationIdental LLC
    Address1320 S Green Bay Rd
    CityMt Pleasant
    StateWI
    ZIP53406
    TaxonomyDentist
    NPI EnumeratedDecember 1, 2015

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$11.7M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    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 CodeDescriptionClaimsAvg PaidRevenue
    D8670N/A17,880$130$2.4M
    D8080N/A940$1,100$1M
    D2392Post 2 surface resin‑based composite9,980$80$798K
    D0330N/A14,280$50$742.3K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)7,070$80$572.3K
    D0140Limited oral evaluation – problem focused17,680$30$565.7K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth14,920$40$537.1K
    D2391Resin‑based composite – one surface, posterior7,570$60$461.8K
    D1351Sealant - per tooth15,870$30$460.3K
    D0220Intraoral - periapical first radiographic image30,020$10$390.3K

    Showing 1–10 of 45

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Wisconsin median

    45 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    D8670N/A9802,010$110$635.7K
    D8080N/A740100$950$428.8K
    D7210Extraction, 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…43120490$100$179.5K
    D7230N/A2230110$180$163.8K
    D2392Post 2 surface resin‑based composite9270510$60$123.3K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)20220430$50$111.4K
    D1351Sealant - per tooth283401,020$20$90.2K
    D2393Resin-based composite, three surfaces, posterior11140270$70$72.8K
    D2391Resin‑based composite – one surface, posterior13240300$50$71.8K
    D1120Prophylaxis–child27520460$30$62.6K

    Showing 1–10 of 45

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Familia Dental Racine LLCWIDental Clinic/Center$0$17.9M
    Developmental Disabilities Information Service, Inc.WICase Management Agency$0$10.9M
    Beta Diagnostic Labs LLCWIClinical Medical Laboratory$1.7M$8.4M
    Mynt Dental Racine LLCWIGeneral Practice Dentistry$0$4.2M
    Covid Care Zone IncWIClinical Medical Laboratory$71.4K$3.6M
    Sweet Smiles Mt. Pleasant LLCWIGeneral Practice Dentistry$0$3.6M
    Chad Novasic Pt LtdWIPhysical Therapist$0$2.6M
    Paramount Pediatric Dentistry Of RacineWIPediatric Dentistry$0$2.3M
    Sasan MolaviWIDentist$0$2.1M
    Wisconsin SmilesWIDental Clinic/Center$0$1.4M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Wisconsin Providers
    6 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Wisconsin Distribution
    Idental LLC — 13 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Wisconsin