Provider 1124460126
Total Paid
$10.2M
$10,249,209
Total Claims
226K
Beneficiaries
206K
1.1 claims/patient
Avg Cost/Claim
$45
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (D2392 (Resin-based composite, two surfaces, posterior)) accounts for 11% of total spending.
$1.1M
14K claims
$75.48
$71.00
Resin-based composite, two surfaces, posterior
$1.1M
14K claims · 10.7%
$939K
3,191 claims
$294.30
$509.58
Crown, porcelain/ceramic substrate
$939K
3,191 claims · 9.2%
Periodontal scaling, per quadrant
$937K
3,937 claims · 9.1%
Prophylaxis, adult
$895K
22K claims · 8.7%
$848K
30K claims
$27.94
$24.34
Periodic oral evaluation, established patient
$848K
30K claims · 8.3%
Sealant, per tooth
$779K
9,546 claims · 7.6%
$567K
22K claims
$26.03
$14.36
Topical application of fluoride, excluding varnish
$567K
22K claims · 5.5%
Prophylaxis, adult cleaning
$414K
9,463 claims · 4.0%
$402K
5,230 claims
$76.92
$109.42
Extraction, erupted tooth, surgical approach
$402K
5,230 claims · 3.9%
$386K
5,775 claims · 3.8%
$354K
1,746 claims · 3.5%
$325K
18K claims
$17.87
$22.54
Bitewings, four radiographic images
$325K
18K claims · 3.2%
$306K
4,847 claims
$63.07
$57.39
Extraction, erupted tooth or exposed root
$306K
4,847 claims · 3.0%
$230K
13K claims
$17.66
$27.07
Limited oral evaluation, problem focused
$230K
13K claims · 2.2%
$221K
9,900 claims
$22.31
$32.07
Comprehensive oral evaluation, new or established patient
$221K
9,900 claims · 2.2%
$219K
2,715 claims
$80.77
$84.26
Resin-based composite, three surfaces, posterior
$219K
2,715 claims · 2.1%
$200K
3,673 claims · 2.0%
$157K
1,844 claims
$85.17
$73.58
Resin-based composite filling, two surfaces, anterior
$157K
1,844 claims · 1.5%
$146K
641 claims
$228.39
$185.01
Periodic orthodontic treatment visit
$146K
641 claims · 1.4%
$135K
2,998 claims
$44.88
$54.60
Resin-based composite, one surface, posterior
$135K
2,998 claims · 1.3%
$127K
1,304 claims · 1.2%
$104K
18K claims
$5.73
$10.51
Intraoral periapical radiographic image, first film
$104K
18K claims · 1.0%
$101K
394 claims
$255.78
$445.23
Crown, porcelain fused to high noble metal
$101K
394 claims · 1.0%
$97K
542 claims · 0.9%
$61K
10K claims
$5.92
$7.33
Intraoral, periapical radiographic image, first film
$61K
10K claims · 0.6%
Panoramic radiographic image
$58K
3,043 claims · 0.6%
$34K
890 claims · 0.3%
$31K
2,707 claims
$11.62
$46.33
Intraoral, complete series of radiographic images
$31K
2,707 claims · 0.3%
Therapeutic pulpotomy
$30K
494 claims · 0.3%
$25K
2,457 claims
$10.00
$15.81
Bitewings, two radiographic images
$25K
2,457 claims · 0.2%