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

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

Great Falls Pediatric Dentistry, LLC (NPI 1922479047)

Field	Value
Entity Type	Organization
Organization	Great Falls Pediatric Dentistry, LLC
Address	1717 4th St S
City	Great Falls
State	MT
ZIP	59405
Taxonomy	Pediatric Dentistry
NPI Enumerated	October 15, 2015

Payer Source	Total Paid
Medicaid	$14.9M
Medicare	$0

Key Findings

This provider reports no Medicare billing on file and is effectively a single-payer (Medicaid) billing entity, with lifetime Medicaid revenue of $14.9M. The NPI was enumerated 2015-10-15 (~11 years ago), indicating an established presence in the market with nearly a decade of claims history under this NPI.

Revenue is highly concentrated in a few Medicaid codes: the top three codes — D2930 ($2.1M, 14.2%), D1120 ($1.8M, 12.4%), and D1206 ($1.6M, 10.9%) — together account for 37.4% of the provider's total Medicaid revenue. This concentration shows a reliance on a limited set of high-volume pediatric-dental services for a large share of Medicaid receipts.

The code mix indicates a strong pediatric preventive care focus: D1120 (Prophylaxis–child) shows 54.7K claims and $1.8M revenue, and D1206 (Topical Fluoride Treatment) shows 79.2K claims and $1.6M revenue, while D1351 (Sealant - per tooth) accounts for $944.3K. These volumes and code types point to an operation centered on high-throughput preventive visits and routine pediatric dental maintenance.

The provider also delivers substantial restorative and operative pediatric services: D2392 (Post 2 surface resin‑based composite) generated $543.8K, D2391 and D2392 together reflect notable composite restoration activity, and D7140 (extraction) produced $692K from 10.2K claims. This mix of preventive, restorative, and extraction codes suggests a full-service pediatric dental practice capable of both routine prevention and common operative care for children.

The provider is a dominant statewide player for many pediatric dental codes: examples include D1120 (ranks #1 of 180 providers in-state, 100th percentile; extreme outlier), D1206 (ranks #1 of 259, 100th percentile; extreme outlier), and D0120 (ranks #1 of 298, 100th percentile; extreme outlier). Repeated #1 rankings and 100th-percentile designations across multiple high-volume codes indicate market leadership in Montana pediatric dentistry for Medicaid populations.

Several codes show unusually high pandemic-era ancillary activity for a dental practice: D0603 (Antigen testing) appears with 34.2K claims and $308.2K revenue and ranks #1 of 46 providers in-state (100th percentile; extreme outlier). The sizable D0603 volume suggests the practice provided extensive COVID antigen testing alongside dental services, an atypical revenue stream for a pediatric dental taxonomy.

Volume metrics reveal a high-throughput operating model: multiple preventive codes have very large claim counts with modest per-claim payments (e.g., D1206 79.2K claims at $20 avg paid/claim; D1120 54.7K claims at $33 avg paid/claim), indicating dependence on scale to generate Medicaid revenue. This pattern is consistent with clinics focused on serving large pediatric Medicaid populations through frequent, routine services.

While the provider is an extreme outlier on many codes, some service lines are more typical relative to peers: D2392 ranks #12 of 131 providers in-state (92th percentile; typical, unremarkable volume) and D8670 ranks #18 of 31 providers (43th percentile; typical, unremarkable volume). This indicates that, despite broad statewide dominance in preventive pediatric codes, the provider’s position is more ordinary in select restorative or specialty procedure categories.

Medicaid: Complete Services Breakdown

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

40 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2930	N/A	17,320	$120	$2.1M
D1120	Prophylaxis–child	54,740	$30	$1.8M
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	79,160	$20	$1.6M
D0120	Periodic oral evaluation - established patient	49,060	$20	$1.2M
D1310	N/A	27,140	$40	$1M
D1351	Sealant - per tooth	39,350	$20	$944.3K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	10,180	$70	$692K
D1330	N/A	27,140	$20	$597.1K
D2392	Post 2 surface resin‑based composite	4,420	$120	$543.8K
D9630	N/A	33,090	$20	$529.4K

Showing 1–10 of 40

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Great Falls Pediatric Dentistry, LLC — 19 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

40 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	1	20	2,090	$120	$493.4K
D8080	N/A	8	10	80	$2,020	$436K
D8670	N/A	18	30	4,310	$80	$432.6K
D8070	N/A	2	10	50	$2,270	$218.1K
D2392	Post 2 surface resin‑based composite	12	130	310	$120	$173.4K
D9248	N/A	5	20	530	$140	$150.4K
D2929	N/A	5	10	400	$190	$126.3K
D1310	N/A	1	50	520	$40	$119.6K
D1351	Sealant - per tooth	1	60	590	$30	$101.4K
D1120	Prophylaxis–child	1	180	200	$30	$88.4K

Showing 1–10 of 40

Nearby Providers

Other providers in the same ZIP code as Great Falls Pediatric Dentistry, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Benefis Hospitals Inc	MT	Multi-Specialty Clinic/Center	$0	$38.2M
Great Falls Public Schools	MT	Local Education Agency (LEA)	$0	$15M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$13.2M
Great Falls Clinic LLC	MT	Multi-Specialty Clinic/Center	$0	$11.2M
Easterseals-goodwill Northern Rocky Mountain, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$7.4M
Levi C Maltby Dmd P.C.	MT	Dentist	$0	$6M
Great Falls Emergency Services Inc	MT	Land Ambulance	$842.6K	$4.4M
Benefis Hospitals, Inc.	MT	Air Ambulance	$0	$5.2M
Easterseals Goodwill N. Rocky Mtn	MT	Developmentally Disabled Services Day Training Agency	$0	$3.7M
Benefis Hospitals, Inc.	MT	General Acute Care Hospital	$0	$3.5M

Great Falls Pediatric Dentistry, LLC — Billing Profile & Reimbursement Data

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Great Falls Pediatric Dentistry, 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

Nearby Providers

Frequently Asked Questions

References