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

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

Nancy Pancko (NPI 1881946333)

Field	Value
Entity Type	Individual
Organization	Nancy Pancko
Address	2300 Pennsylvania Ave
City	Wilmington
State	DE
ZIP	19806
Taxonomy	Orthodontics and Dentofacial Orthopedics Dentistry
NPI Enumerated	October 9, 2012

Payer Source	Total Paid
Medicaid	$10M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively a Medicaid-focused practice, with lifetime Medicaid revenue of $10M; the absence of Medicare activity means analysis and payer strategy should be centered entirely on Medicaid relationships and utilization patterns. The NPI was enumerated on 2012-10-09 (~14 years ago), indicating an established presence in the market rather than a new entrant.

Revenue is highly concentrated: the top three Medicaid codes account for 95.5% of this provider's total Medicaid revenue. D8670 alone represents 61.8% of Medicaid revenue ($6.2M), followed by D8090 at 22.5% ($2.2M) and D8660 at 11.3% ($1.1M), meaning a small set of procedures drives nearly all Medicaid payments to this provider.

The provider’s taxonomy is Orthodontics and Dentofacial Orthopedics Dentistry and the code mix supports a narrow specialty operation: very high-volume, lower-average-paid encounters (D8670: 24.6K claims, $250 avg paid/claim) combined with a smaller number of much higher-paid procedures (D8090: 1.1K claims, $2048 avg paid/claim). This pattern is consistent with an orthodontic practice that delivers frequent routine visits or adjustments alongside less frequent, resource-intensive procedures.

Competitive standing within the state is strong on the highest-revenue code: D8670 ranks #1 of 20 providers in-state and is described as notably above typical state volume for this code, marking the provider as a statewide leader for that service line. D8660 also ranks highly (#2 of 14) and is described as notably above typical state volume, while D8090 ranks #2 of 12 but is described as a typical, unremarkable volume for that code, indicating leadership on some codes and parity on others.

Claim-level economics vary sharply across codes, signaling different operational roles: D8670 (24.6K claims at $250 avg) generates the largest share through volume, whereas D8090 produces 22.5% of revenue from only 1.1K claims at a $2048 avg paid/claim. D0150 shows 3.5K claims but only $235.5K in revenue (2.4% of total), which suggests many low-reimbursement evaluation encounters contribute to visit volume without materially affecting revenue.

There are multiple codes with claims recorded but $0 avg paid/claim in the dataset (D0601, D0603, D1206, D0274, D0602), including D0602 with 3.3K claims and $0 reported revenue. These zero-paid claim lines are small contributors to revenue but notable for volume and should be reviewed for billing eligibility, claim denials, or reporting artifacts rather than interpreted as meaningful revenue drivers.

From a payer risk and utilization-management perspective, the extreme revenue concentration (95.5% across three codes and 61.8% from a single code D8670) highlights a focused set of services to target for audit, medical necessity review, or rate negotiations. Given the provider’s dominance on D8670 in-state and the significant contribution of D8090 and D8660 to total Medicaid receipts, any policy or reimbursement changes affecting these codes could materially impact the provider’s Medicaid revenue.

Operationally, the mix of high-volume, lower-paid claims and lower-volume, high-paid claims suggests this practice balances frequent patient visits with episodic higher-cost interventions; payers evaluating network value or carve-out opportunities should model impact using the exact code-level concentrations reported (D8670 61.8%, D8090 22.5%, D8660 11.3%). The established tenure (~14 years) supports stability in these patterns rather than a transient billing spike.

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D8670	N/A	24,600	$250	$6.2M
D8090	N/A	1,090	$2,050	$2.2M
D8660	N/A	3,590	$310	$1.1M
D0150	Comprehensive oral evaluation – new or established patient	3,460	$70	$235.5K
D8020	N/A	90	$2,320	$211.4K
D0274	N/A	10	$0	$0
D0602	N/A	3,270	$0	$0
D0603	Antigen testing for a public health-related pathogen, including coronavirus (COVID-19), using a high throughput technique, per day	30	$0	$0
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	20	$0	$0
D0601	N/A	730	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Nancy Pancko — 1 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D8670	N/A	1	20	2,720	$230	$1.2M
D8020	N/A	6	10	120	$2,450	$950.3K
D8090	N/A	2	10	200	$1,910	$774.6K
D8660	N/A	2	10	810	$330	$422.7K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	122	130	1,220	$30	$116.9K
D0274	N/A	121	130	330	$50	$57.4K
D0150	Comprehensive oral evaluation – new or established patient	11	150	260	$60	$53.2K
D0603	Antigen testing for a public health-related pathogen, including coronavirus (COVID-19), using a high throughput technique, per day	82	90	1,060	$1	$150
D0602	N/A	12	90	460	$1	$20
D0601	N/A	19	80	170	$1	$10

Related Providers

Other providers that share a Tax Identification Number (TIN) with Nancy Pancko, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wilmington Orthodontic Center	DE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$3.8M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ingleside Homes, Inc	DE	Assisted Living Facility	$0	$2.5M
Paula Ko	DE	Ophthalmology Physician	$1.7M	$0
Liberty Dialysis - Wilmington LLC	DE	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Eye Physicians & Surgeons, PA	DE	Ophthalmology Physician	$0	$1.6M
Brandywine Medical Associates, Inc.	DE	Family Medicine Physician	$0	$1.3M
Brian Toussaint	DE	Ophthalmology Physician	$1.2M	$0
Ingleside Homes, Inc	DE	Homemaker	$0	$1.2M
Rmb Group, LLC	DE	In Home Supportive Care Agency	$0	$1.1M
Philip Schwartz	DE	Rheumatology Physician	$937.1K	$0
Anthony Vattilana	DE	General Practice Dentistry	$0	$668.6K

Nancy Pancko — Billing Profile & Reimbursement Data

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Nancy Pancko — 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