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

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

Sandra Fox (NPI 1952666307)

Field	Value
Entity Type	Individual
Organization	Sandra Fox
Address	2001 N 6th St
City	Indianola
State	IA
ZIP	50125
Taxonomy	Pediatric Dentistry
NPI Enumerated	July 11, 2012

Payer Source	Total Paid
Medicaid	$850.3K
Medicare	$0

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2930	N/A	2,160	$100	$213.6K
D1120	Prophylaxis–child	5,150	$30	$149.3K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	5,190	$20	$88.2K
D0120	Periodic oral evaluation - established patient	4,380	$20	$87.7K
D1351	Sealant - per tooth	2,220	$20	$46.5K
D0272	N/A	2,250	$20	$38.3K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	650	$50	$33K
D0220	Intraoral - periapical first radiographic image	2,620	$10	$31.4K
D0230	Intraoral - periapical each additional radiographic image	2,860	$10	$25.7K
D2391	Resin‑based composite – one surface, posterior	450	$50	$24.4K

Showing 1–10 of 20

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Sandra Fox — 0 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	22	80	850	$110	$217.2K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	62	170	330	$50	$88.3K
D1351	Sealant - per tooth	60	190	750	$20	$60.2K
D2392	Post 2 surface resin‑based composite	105	210	230	$60	$58.6K
D3220	N/A	33	40	190	$80	$55.5K
D1120	Prophylaxis–child	44	580	310	$20	$43.3K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	331	630	370	$30	$36.8K
D2391	Resin‑based composite – one surface, posterior	66	190	210	$40	$34.7K
D0120	Periodic oral evaluation - established patient	93	830	530	$20	$34.1K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	71	630	500	$10	$33.3K

Showing 1–10 of 20

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Clinics, Inc.	IA	Primary Care Clinic/Center	$0	$2.8M
City Of Indianola	IA	Land Ambulance	$223K	$821.3K
Hy-vee Inc	IA	Community/Retail Pharmacy	$237.9K	$39.4K
Sarah Olsasky	IA	Family Medicine Physician	$181.6K	$0
David Gabel	IA	Family Medicine Physician	$170.5K	$0
Chris Jensen	IA	Family Medicine Physician	$145.9K	$0
Candice Smith	IA	Family Medicine Physician	$139.5K	$0
Megan Lehr	IA	Family Medicine Physician	$117.8K	$0
Samuel Gastineau	IA	Family Medicine Physician	$111.6K	$0
Barbara White	IA	Family Medicine Physician	$28.9K	$0

Sandra Fox — Billing Profile & Reimbursement Data

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Sandra Fox — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References