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

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

Mainely Smiles (NPI 1992391536)

Field	Value
Entity Type	Organization
Organization	Mainely Smiles
Address	117 Auburn St
City	Portland
State	ME
ZIP	04103
Taxonomy	Public Health Dentistry
NPI Enumerated	December 17, 2020

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1120	Prophylaxis–child	4,880	$50	$234.1K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	7,130	$20	$164K
D1354	N/A	6,150	$30	$159.9K
D0190	N/A	7,250	$20	$145K
D1351	Sealant - per tooth	3,240	$30	$97.3K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	1,240	$60	$79.2K
D2940	N/A	1,260	$60	$74.2K
D4341	Periodontal scaling and root planing - four or more teeth per quadrant	290	$130	$36.8K
D0274	N/A	800	$40	$34.4K
D0140	Limited oral evaluation – problem focused	580	$60	$33K

Showing 1–10 of 29

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maine Distribution

Mainely Smiles — 1 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D5110	N/A	8	10	180	$610	$170.1K
D2392	Post 2 surface resin‑based composite	74	80	260	$80	$88.2K
D1351	Sealant - per tooth	24	80	1,040	$20	$87.6K
D1120	Prophylaxis–child	17	160	500	$30	$56.2K
D2940	N/A	7	20	400	$50	$50.1K
D0120	Periodic oral evaluation - established patient	54	140	480	$20	$46.8K
D1354	N/A	4	50	620	$20	$43.9K
D0150	Comprehensive oral evaluation – new or established patient	41	100	310	$50	$39.3K
D0330	N/A	57	110	240	$40	$36.8K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	33	160	300	$40	$34.6K

Showing 1–10 of 29

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Granite Bay Care, Inc	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$281.6M
Spurwink Services	ME	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$112.7M
Cor Health Services LLC	ME	Home Health Agency	$0	$55.9M
Spurwink Services Incorporated	ME	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$52.9M
Casa, Inc.	ME	Adult Care Home Facility	$0	$50.1M
Gateway Community Services, LLC	ME	Community/Behavioral Health Agency	$0	$30.2M
Peregrine Corporation	ME	Case Management Agency	$0	$30M
Ubuntu Care	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$27.3M
New England Integrated Living Support	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$22.3M
Affinity	ME	Developmentally Disabled Services Day Training Agency	$0	$9.7M

Mainely Smiles — Billing Profile & Reimbursement Data

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Mainely Smiles — Billing Profile & Reimbursement Data

Sign up for Mainely Smiles — 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