Total Paid
$21.0M
$21,044,588
Total Claims
551K
Beneficiaries
449K
1.2 claims/patient
Avg Cost/Claim
$38
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 40 distinct procedure codes. The top code (D1120 (Prophylaxis, adult)) accounts for 15% of total spending.
Prophylaxis, adult
$3.1M
78K claims · 14.8%
$2.4M
27K claims
$89.13
$71.00
Resin-based composite, two surfaces, posterior
$2.4M
27K claims · 11.4%
$1.8M
73K claims
$24.41
$18.12
Topical application of fluoride varnish
$1.8M
73K claims · 8.4%
$1.6M
54K claims
$29.86
$24.34
Periodic oral evaluation, established patient
$1.6M
54K claims · 7.6%
$1.5M
31K claims
$48.69
$32.07
Comprehensive oral evaluation, new or established patient
$1.5M
31K claims · 7.3%
$1.5M
20K claims
$75.11
$54.60
Resin-based composite, one surface, posterior
$1.5M
20K claims · 7.2%
Panoramic radiographic image
$1.3M
24K claims · 6.3%
Sealant, per tooth
$1.2M
35K claims · 5.9%
$1.1M
17K claims
$65.92
$185.01
Periodic orthodontic treatment visit
$1.1M
17K claims · 5.4%
Bitewings, four radiographic images
$1.1M
32K claims · 5.1%
Bitewings, two radiographic images
$660K
27K claims · 3.1%
$504K
37K claims
$13.61
$10.51
Intraoral periapical radiographic image, first film
$504K
37K claims · 2.4%
$372K
12K claims
$31.05
$27.07
Limited oral evaluation, problem focused
$372K
12K claims · 1.8%
$367K
30K claims
$12.11
$7.33
Intraoral, periapical radiographic image, first film
$367K
30K claims · 1.7%
$344K
3,747 claims
$91.87
$57.39
Extraction, erupted tooth or exposed root
$344K
3,747 claims · 1.6%
$339K
3,137 claims
$108.18
$84.26
Resin-based composite, three surfaces, posterior
$339K
3,137 claims · 1.6%
Prophylaxis, adult cleaning
$289K
9,457 claims · 1.4%
$283K
1,783 claims
$158.46
$120.85
Prefabricated stainless steel crown, primary tooth
$283K
1,783 claims · 1.3%
$219K
802 claims
$272.65
$231.00
Extraction, impacted tooth, complete bony
$219K
802 claims · 1.0%
$176K
3,175 claims · 0.8%
$171K
7,574 claims
$22.63
$14.36
Topical application of fluoride, excluding varnish
$171K
7,574 claims · 0.8%
$126K
5,976 claims · 0.6%
Therapeutic pulpotomy
$99K
929 claims · 0.5%
$80K
2,187 claims
$36.51
$26.24
Inhalation of nitrous oxide/analgesia, anxiolysis
$80K
2,187 claims · 0.4%
$77K
1,043 claims
$73.70
$109.42
Extraction, erupted tooth, surgical approach
$77K
1,043 claims · 0.4%
$68K
139 claims
$488.64
$968.00
Comprehensive orthodontic treatment, adolescent dentition
$68K
139 claims · 0.3%
$49K
597 claims · 0.2%
$35K
161 claims
$214.37
$187.09
Extraction, impacted tooth, partial bony
$35K
161 claims · 0.2%
$24K
191 claims · 0.1%
$21K
70 claims · 0.1%
$18K
138 claims · 0.1%
$9K
124 claims
$72.67
$66.63
Resin-based composite filling, one surface, anterior
$9K
124 claims · 0.0%
$8K
94 claims · 0.0%
$8K
153 claims
$53.13
$52.77
Amalgam, one surface, primary or permanent
$8K
153 claims · 0.0%
$7K
93 claims
$74.27
$66.00
Amalgam, two surfaces, primary or permanent
$7K
93 claims · 0.0%
$5K
54 claims
$98.35
$73.58
Resin-based composite filling, two surfaces, anterior
$5K
54 claims · 0.0%
$2K
356 claims · 0.0%
$0
13K claims · 0.0%
$0
95 claims · 0.0%
$0
22 claims · 0.0%
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