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#52 of 11K

D0120

Periodic oral evaluation, established patient

Periodic oral evaluation, established patient is the #52 most-billed Medicaid procedure code, with $3.81B in payments across 136.2M claims from 2018–2024. The national median cost per claim is $24.34.

Total Paid

$3.81B

0.35% of all spending

Total Claims

136.2M

Providers

53K

Avg Cost/Claim

$28

National Cost Distribution

How much do providers bill per claim for D0120? Based on 51K providers billing this code nationally.

Median

$24.34

Average

$28.49

Std Dev

$34.09

Max

$1,569.23

Percentile Distribution (Cost per Claim)

p10
$13.85
p25
$19.58
Median
$24.34
p75
$28.05
p90
$45.00
p95
$60.27
p99
$98.40

50% of providers bill between $19.58 and $28.05 per claim for this code.

90% bill between $13.85 and $45.00.

Top 1% bill above $98.40.

About This Procedure

HCPCS code D0120 (Periodic oral evaluation, established patient) was billed by 53K providers across 136.2M claims, totaling $3.81B in Medicaid payments from 2018–2024. This code was used for 130.5M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$24.34

Providers Billing

51K

National Spending

$3.81B

Avg/Median Ratio

1.17×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for D0120

#ProviderTotal Paid
11205922705$9.1M
2Candler Road Dental, Pc

Decatur, GA · Dentist, Endodontics

$8.7M
3Rock Dental Arkansas Pllc

Hot Springs, AR · Dentist, Orthodontics and Dentofacial Orthopedics

$8.5M
41669726048$7.8M
5Smile New York Outreach Llc

Long Island City, NY · Clinic/Center Dental

$7.6M
61821486754$7.5M
71841638624$6.8M
81992892616$6.6M
9Marn Dds Dental Practice P.c.

Los Angeles, CA · Dentist General Practice

$6.3M
101609273101$6.2M
111255638284$6.1M
12My Community Dental Centers Inc

Petoskey, MI · Dentist, Dental Public Health

$6.0M
13Nyu Langone Hospitals

Brooklyn, NY · General Acute Care Hospital

$5.8M
141467635243$5.7M
151285834796$5.7M
16D4c Of Texas Pllc

Austin, TX · Clinic/Center, Dental

$5.7M
17Children's Hospital Of Wisconsin, Inc.

Milwaukee, WI · Dentist, Pediatric Dentistry

$5.6M
181366772402$5.3M
191013299411$5.3M
201669065470$5.2M

Showing top 20 of 53K providers billing this code

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