Provider 1174948574
Total Paid
$9.5M
$9,526,478
Total Claims
86K
Beneficiaries
30K
2.9 claims/patient
Avg Cost/Claim
$110
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 10 distinct procedure codes. The top code (D9223 (Deep sedation/general anesthesia, each additional 15 min)) accounts for 80% of total spending.
$7.6M
69K claims
$109.78
$107.14
Deep sedation/general anesthesia, each additional 15 min
$7.6M
69K claims · 79.5%
$1.6M
14K claims
$112.03
$90.28
Deep sedation/general anesthesia, first 15 minutes
$1.6M
14K claims · 17.0%
$205K
1,008 claims
$203.37
$120.85
Prefabricated stainless steel crown, primary tooth
$205K
1,008 claims · 2.2%
$54K
519 claims
$104.75
$57.39
Extraction, erupted tooth or exposed root
$54K
519 claims · 0.6%
$25K
454 claims
$55.04
$32.07
Comprehensive oral evaluation, new or established patient
$25K
454 claims · 0.3%
$17K
467 claims
$36.93
$46.33
Intraoral, complete series of radiographic images
$17K
467 claims · 0.2%
Prophylaxis, adult
$10K
202 claims · 0.1%
$8K
79 claims
$95.24
$54.60
Resin-based composite, one surface, posterior
$8K
79 claims · 0.1%
$6K
204 claims
$28.85
$14.36
Topical application of fluoride, excluding varnish
$6K
204 claims · 0.1%
Sealant, per tooth
$2K
39 claims · 0.0%