Provider 1063710010
Total Paid
$8.8M
$8,829,650
Total Claims
259K
Beneficiaries
175K
1.5 claims/patient
Avg Cost/Claim
$34
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 24 distinct procedure codes. The top code (D2930 (Prefabricated stainless steel crown, primary tooth)) accounts for 32% of total spending.
$2.8M
25K claims
$111.22
$120.85
Prefabricated stainless steel crown, primary tooth
$2.8M
25K claims · 31.8%
$1.4M
21K claims
$63.65
$57.39
Extraction, erupted tooth or exposed root
$1.4M
21K claims · 15.5%
Prophylaxis, adult
$787K
36K claims · 8.9%
$577K
34K claims
$16.90
$14.36
Topical application of fluoride, excluding varnish
$577K
34K claims · 6.5%
$536K
3,128 claims · 6.1%
$472K
25K claims
$19.14
$24.34
Periodic oral evaluation, established patient
$472K
25K claims · 5.3%
Therapeutic pulpotomy
$378K
4,831 claims · 4.3%
Panoramic radiographic image
$332K
5,656 claims · 3.8%
$286K
28K claims · 3.2%
$269K
11K claims
$25.60
$27.07
Limited oral evaluation, problem focused
$269K
11K claims · 3.1%
$245K
7,837 claims
$31.20
$32.07
Comprehensive oral evaluation, new or established patient
$245K
7,837 claims · 2.8%
$234K
22K claims
$10.53
$15.81
Bitewings, two radiographic images
$234K
22K claims · 2.7%
$169K
1,209 claims · 1.9%
$107K
3,458 claims
$31.07
$26.24
Inhalation of nitrous oxide/analgesia, anxiolysis
$107K
3,458 claims · 1.2%
$85K
15K claims
$5.69
$10.51
Intraoral periapical radiographic image, first film
$85K
15K claims · 1.0%
$62K
12K claims
$5.01
$7.33
Intraoral, periapical radiographic image, first film
$62K
12K claims · 0.7%
$46K
915 claims
$50.24
$66.00
Amalgam, two surfaces, primary or permanent
$46K
915 claims · 0.5%
$27K
691 claims
$39.19
$52.77
Amalgam, one surface, primary or permanent
$27K
691 claims · 0.3%
$22K
446 claims
$48.87
$54.60
Resin-based composite, one surface, posterior
$22K
446 claims · 0.2%
$11K
353 claims
$31.77
$46.33
Intraoral, complete series of radiographic images
$11K
353 claims · 0.1%
$9K
182 claims
$51.43
$71.00
Resin-based composite, two surfaces, posterior
$9K
182 claims · 0.1%
Sealant, per tooth
$739
43 claims · 0.0%
$377
79 claims · 0.0%
$0
335 claims · 0.0%