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

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

Avalon Dental PC (NPI 1962850933)

Field	Value
Entity Type	Organization
Organization	Avalon Dental PC
Address	672 E Wythe Creek Ct
City	Kuna
State	ID
ZIP	83634
Taxonomy	Dental Clinic/Center
NPI Enumerated	May 31, 2016

Payer Source	Total Paid
Medicaid	$389.8K
Medicare	$0

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1120	Prophylaxis–child	2,420	$70	$172.1K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	1,700	$100	$161.2K
D2393	Resin-based composite, three surfaces, posterior	340	$100	$32.7K
D2392	Post 2 surface resin‑based composite	150	$50	$8.3K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	100	$50	$5.2K
D0274	N/A	1,660	$1	$3.3K
D0150	Comprehensive oral evaluation – new or established patient	60	$50	$3.2K
D1351	Sealant - per tooth	3,220	$1	$3.2K
D0330	N/A	10	$50	$590
D0120	Periodic oral evaluation - established patient	3,810	$0	$0

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Avalon Dental PC — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D1120	Prophylaxis–child	43	250	180	$60	$143K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	54	320	310	$80	$80.8K
D2392	Post 2 surface resin‑based composite	122	190	280	$60	$72.9K
D2393	Resin-based composite, three surfaces, posterior	22	70	140	$120	$41.6K
D0330	N/A	158	170	170	$50	$35.6K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	76	110	300	$30	$32.4K
D0150	Comprehensive oral evaluation – new or established patient	162	220	220	$30	$21.2K
D1351	Sealant - per tooth	34	120	640	$1	$10.3K
D0274	N/A	50	260	240	$10	$7.3K
D0120	Periodic oral evaluation - established patient	41	350	400	$1	$5.7K

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as Avalon Dental PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kuna Joint School District No.3	ID	Local Education Agency (LEA)	$0	$6.7M
Kuna Counseling Center	ID	Community/Behavioral Health Agency	$0	$2.5M
Deluxe Dental Group Kuna	ID	General Practice Dentistry	$0	$1.4M
Bestlife Care, Inc	ID	Assisted Living Facility	$0	$782.1K
Swan Falls Assisted Living	ID	Assisted Living Facility	$0	$677K
Sara Mitchem	ID	Psychiatric/Mental Health Nurse Practitioner	$32.4K	$0

Avalon Dental PC — Billing Profile & Reimbursement Data

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Avalon Dental PC — Billing Profile & Reimbursement Data

Sign up for Avalon Dental PC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References