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.

Gabriel Dawson (NPI 1972921450)

Field	Value
Entity Type	Individual
Organization	Gabriel Dawson
Address	795 Sunset Blvd Ste C
City	Kalispell
State	MT
ZIP	59901
Taxonomy	Pediatric Dentistry
NPI Enumerated	April 2, 2014

Payer Source	Total Paid
Medicaid	$10.7M
Medicare	$0

Key Findings

Payer mix and scale: This provider reports no Medicare billing on file and $10.7M in lifetime Medicaid revenue, so operations are effectively single‑payer (Medicaid) in scope. The absence of Medicare activity indicates the practice’s revenue and utilization profile should be interpreted through a Medicaid-centered lens rather than a mixed Medicare/Medicaid model.

Revenue concentration: The practice’s top three Medicaid revenue drivers — D2392 ($1.8M, 17.0% of total), D2930 ($1.2M, 11.1% of total), and D1120 ($1.0M, 10.0% of total) — together account for 38.2% of its Medicaid revenue. This concentration means a relatively small set of procedures generates a large share of reimbursement, so changes in coverage, rates, or utilization for these codes would materially affect overall revenue.

Business/service-line implications — preventive services: Multiple high-volume preventive codes are prominent (D1120 – 29.9K claims, $1M; D0120 – 32.4K claims, $842.6K; D1206 – 33.1K claims, $727.1K; D1351 – 16.1K claims, $483.7K), which, together with the Pediatric Dentistry taxonomy, indicates the practice predominantly delivers preventive pediatric dentistry at scale. The large counts for prophylaxis, periodic exams, topical fluoride, and sealants suggest this provider serves a high throughput of children—likely routine, school‑age preventive care.

Business/service-line implications — restorative services: High-revenue restorative codes appear alongside prevention, with D2392 (post 2‑surface composite; $1.8M, 12.9K claims), D2391 (one-surface posterior; $465.4K, 5.7K claims), and D2393 (three-surface posterior; $431.3K, 2.4K claims) showing substantial restorative volume. The mix of preventive and restorative codes indicates a full-service pediatric dental practice that manages both routine prevention and a meaningful caseload of operative dentistry.

Imaging and diagnostic utilization: Imaging codes are also heavily used—D0220 has 11.2K claims and $201.5K revenue and ranks #2 of 145 providers in-state (99th percentile), while D0272 and D0240 show large claims and high state percentiles as well. This pattern points to routine use of intraoral radiographs and other imaging as part of care workflows, consistent with a high-volume pediatric clinic that performs diagnostics alongside preventive and restorative visits.

Competitive standing in-state: Multiple codes rank at or near the top statewide (examples: D2392 #2 of 131, 99th percentile, labeled an "extreme outlier"; D1120 #5 of 180, 98th percentile, labeled an "extreme outlier"; D0220 #2 of 145, 99th percentile), indicating this provider is a dominant Medicaid participant for several pediatric dental services in Montana. While some codes (e.g., D2930 at the 86th percentile) are more typical, the overall pattern is one of above‑typical to extreme volume across numerous pediatric dentistry codes.

Tenure and market presence: The provider’s NPI was enumerated on 2014-04-02 (~12 years ago), indicating over a decade of presence in the Medicaid market. That tenure, combined with sustained high volumes across preventive, restorative, and imaging codes, suggests an established practice with stable patient flow and integration into the Medicaid pediatric dental ecosystem.

Operational implications for payers and network planners: Given the practice’s heavy Medicaid concentration, high throughput preventive services, and outsized state rankings on multiple codes, payers should view this entity as a major source of pediatric dental capacity. Contracting, network adequacy assessments, and utilization-management efforts targeting pediatric dental care in the region would be materially influenced by this provider’s volume profile.

Medicaid: Complete Services Breakdown

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

41 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2392	Post 2 surface resin‑based composite	12,880	$140	$1.8M
D2930	N/A	8,540	$140	$1.2M
D1120	Prophylaxis–child	29,880	$40	$1M
D0120	Periodic oral evaluation - established patient	32,410	$30	$842.6K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	33,050	$20	$727.1K
D1351	Sealant - per tooth	16,120	$30	$483.7K
D2391	Resin‑based composite – one surface, posterior	5,680	$80	$465.4K
D2393	Resin-based composite, three surfaces, posterior	2,380	$180	$431.3K
D1310	N/A	10,180	$40	$407K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	6,450	$50	$342K

Showing 1–10 of 41

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

Gabriel Dawson — 15 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

41 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	4	20	2,090	$120	$493.4K
D2392	Post 2 surface resin‑based composite	2	130	310	$120	$173.4K
D2929	N/A	2	10	400	$190	$126.3K
D1310	N/A	5	50	520	$40	$119.6K
D1351	Sealant - per tooth	4	60	590	$30	$101.4K
D1120	Prophylaxis–child	5	180	200	$30	$88.4K
D1330	N/A	5	60	340	$20	$65.6K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	9	80	290	$50	$59.8K
D2393	Resin-based composite, three surfaces, posterior	2	60	70	$160	$59.6K
D9230	N/A	2	50	250	$30	$55.8K

Showing 1–10 of 41

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Samantha Pyle	MT	Family Medicine Physician	$4.3K	$0
Joseph Chopyak	MT	Physician Assistant	$2.3K	$0
Tony Fantozzi	MT	Medical Physician Assistant	$2.1K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Flathead Industries	MT	Community/Behavioral Health Agency	$0	$40.7M
A Plus Health Care Inc	MT	In Home Supportive Care Agency	$0	$28.2M
Kalispell Regional Medical Center Inc	MT	General Acute Care Hospital	$0	$8.8M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$6.8M
Kiddsteeth PLLC	MT	Pediatric Dentistry	$0	$6.7M
Kalispell Regional Medical Center, Inc	MT	Clinic/Center	$0	$6.2M
Kalispell Public Schools	MT	Local Education Agency (LEA)	$0	$6M
Kalispell Regional Medical Center Inc	MT	Psychiatry Physician	$0	$5.9M
Kalispell Regional Medical Center Inc	MT	Emergency Medicine Physician	$0	$5.4M
Sunburst Community Service Foundation, Inc	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.3M

Gabriel Dawson — Billing Profile & Reimbursement Data

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Gabriel Dawson — 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