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#317 of 11K

D0145

Oral evaluation for patient under 3 years, counseling

Oral evaluation for patient under 3 years, counseling is the #317 most-billed Medicaid procedure code, with $431.2M in payments across 5.6M claims from 2018–2024. The national median cost per claim is $57.30. Costs vary widely — the 90th percentile is $139.40 per claim, 2.4× the median.

Total Paid

$431.2M

0.04% of all spending

Total Claims

5.6M

Providers

7K

Avg Cost/Claim

$77

National Cost Distribution

How much do providers bill per claim for D0145? Based on 7K providers billing this code nationally.

Median

$57.30

Average

$74.16

Std Dev

$51.82

Max

$654.35

Percentile Distribution (Cost per Claim)

p10
$20.40
p25
$30.08
Median
$57.30
p75
$134.05
p90
$139.40
p95
$141.15
p99
$142.07

50% of providers bill between $30.08 and $134.05 per claim for this code.

90% bill between $20.40 and $139.40.

Top 1% bill above $142.07.

About This Procedure

HCPCS code D0145 (Oral evaluation for patient under 3 years, counseling) was billed by 7K providers across 5.6M claims, totaling $431.2M in Medicaid payments from 2018–2024. This code was used for 5.4M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$57.30

Providers Billing

7K

National Spending

$431.2M

Avg/Median Ratio

1.29×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for D0145

#ProviderTotal Paid
1D4c Of Texas Pllc

Austin, TX · Clinic/Center, Dental

$7.0M
21306155353$2.1M
31982089256$1.8M
41902267636$1.8M
51598097438$1.7M
61770954174$1.6M
71225797467$1.6M
81811325970$1.4M
91114156957$1.4M
101821368507$1.3M
111205922705$1.3M
121881079267$1.3M
131073614772$1.3M
141578824835$1.2M
151740765510$1.1M
161306087382$1.1M
171194089771$1.1M
181124360946$1.1M
191336594183$1.0M
201740489681$1.0M

Showing top 20 of 7K providers billing this code