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.

Missoula Pediatric Dentistry PC (NPI 1942483524)

Field	Value
Entity Type	Organization
Organization	Missoula Pediatric Dentistry PC
Address	1300 South Reserve St
City	Missoula
State	MT
ZIP	59801
Taxonomy	Pediatric Dentistry
NPI Enumerated	December 6, 2007

Payer Source	Total Paid
Medicaid	$9.3M
Medicare	$0

Key Findings

Payer mix and scale: MISSOULA PEDIATRIC DENTISTRY PC is effectively a Medicaid-focused practice with Total Medicaid revenue of $9.3M and no Medicare billing on file. The absence of Medicare activity indicates this entity operates as a single-payer (Medicaid) provider in practical terms rather than a mixed Medicare/Medicaid practice, concentrating its revenue risk and access exposure on Medicaid populations.

Revenue concentration: Revenue is materially concentrated in a small number of procedure lines — the precomputed top-3 Medicaid codes account for 36.3% of the provider's total Medicaid revenue. The three highest-revenue codes are D2392 ($1.6M, 17.6%), D1120 ($970.8K, 10.7%), and D1206 ($723.4K, 8.0%), underscoring dependence on a mix of posterior resin restorations and high-volume pediatric preventive services.

Service-line profile: The code mix (D2392, D1120, D1206, plus high counts in D0120 and D0350) corresponds to a high-volume pediatric dentistry practice that delivers both preventive care (prophylaxis, topical fluoride, periodic evaluations) and routine restorative work (posterior resin-based composites). High claim volumes — e.g., D1206 at 34.4K claims and D1120 at 26.2K claims — suggest clinic-level throughput geared toward frequent preventive visits and same-office restorative procedures typical of pediatric-focused group practices.

Competitive standing within state Medicaid: For several key codes this provider is a dominant statewide participant. Examples include D2392 (ranks #3 of 131, 98th percentile; labeled an extreme outlier), D1120 (ranks #6 of 180, 97th percentile; extreme outlier), and D1206 (ranks #5 of 259, 98th percentile; extreme outlier), which together indicate the clinic performs far more of these services than typical in-state peers.

Presence of adult-coded services despite pediatric taxonomy: Although taxonomy is Pediatric Dentistry, the profile includes adult-oriented codes such as D1110 (7.2K claims, $386.6K revenue, ranks #7 of 270, 98th percentile), indicating the practice also bills adult prophylaxis at notable volumes. This mix may reflect treatment of older adolescents or family members, or broader age coverage in clinical operations despite a pediatric focus.

Breadth and acuity of procedures: The dataset shows the practice also delivers higher-acuity procedures (e.g., D7140 extractions: 2.6K claims, $200.2K revenue, 2.2% of Medicaid revenue) and a range of diagnostic imaging and restorative codes (e.g., D0220, D0330, D2391). While extractions and some specialized codes are not the largest revenue drivers, their presence indicates capability to treat acute dental needs in addition to preventive care.

Statistical outliers versus typical volumes: Several individual codes are labeled extreme outliers or notably above typical state volume (e.g., D2391 ranks #2 of 105, 99th percentile; D0350 ranks #1 of 40, 100th percentile), showing exceptional concentration in specific services. At the same time, many billed codes (for example D2930 and D8670) are described as typical or unremarkable in state ranking, signaling that the provider’s exceptional volumes are concentrated in a defined set of pediatric preventive and posterior restoration codes rather than across every service line.

Tenure and market presence: The provider’s NPI was enumerated on 2007-12-06 (~19 years ago), indicating a longstanding presence in the market. Combined with the high volumes and top-state rankings on several codes, this tenure supports interpretation of MISSOULA PEDIATRIC DENTISTRY PC as an established, high-volume Medicaid dental provider in Montana.

Medicaid: Complete Services Breakdown

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

46 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2392	Post 2 surface resin‑based composite	11,940	$130	$1.6M
D1120	Prophylaxis–child	26,240	$40	$970.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	34,450	$20	$723.4K
D0120	Periodic oral evaluation - established patient	26,620	$30	$718.6K
D2930	N/A	3,960	$140	$543.1K
D2391	Resin‑based composite – one surface, posterior	6,220	$70	$447.6K
D1351	Sealant - per tooth	14,340	$30	$444.4K
D8670	N/A	5,210	$80	$416.4K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	7,160	$50	$386.6K
D1310	N/A	9,710	$40	$378.5K

Showing 1–10 of 46

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

Missoula Pediatric Dentistry PC — 11 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

46 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	9	20	2,090	$120	$493.4K
D8670	N/A	13	30	4,310	$80	$432.6K
D2392	Post 2 surface resin‑based composite	3	130	310	$120	$173.4K
D1310	N/A	6	50	520	$40	$119.6K
D1351	Sealant - per tooth	5	60	590	$30	$101.4K
D1120	Prophylaxis–child	6	180	200	$30	$88.4K
D9310	N/A	20	40	450	$50	$74.1K
D1330	N/A	6	60	340	$20	$65.6K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	12	80	290	$50	$59.8K
D2393	Resin-based composite, three surfaces, posterior	9	60	70	$160	$59.6K

Showing 1–10 of 46

Nearby Providers

Other providers in the same ZIP code as Missoula Pediatric Dentistry PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Western Montana Mental Health Center	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$87.8M
Opportunity Resources Inc	MT	Developmentally Disabled Services Day Training Agency	$0	$48.5M
Missoula Developmental Service Corp	MT	Non-emergency Medical Transport (VAN)	$0	$33.6M
Express Personnel Services	MT	Nursing Care Agency	$0	$20.4M
3 Rivers Mental Health Solutions LLC	MT	Community/Behavioral Health Agency	$0	$16.7M
Missoula County Public Schools	MT	Local Education Agency (LEA)	$0	$16.3M
Meadowlark Home Care LLC	MT	Home Health Agency	$0	$12.9M
Client Dedicated Services, Inc	MT	Home Health Agency	$0	$10.6M
Children's Dentistry Of The Rockies	MT	Pediatric Dentistry	$0	$10.1M
Missoula Oral Surgery	MT	Oral and Maxillofacial Surgery Clinic/Center	$0	$8M

Missoula Pediatric Dentistry PC — Billing Profile & Reimbursement Data

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Missoula Pediatric Dentistry 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