Provider 1306008305
Total Paid
$7.8M
$7,787,230
Total Claims
103K
Beneficiaries
91K
1.1 claims/patient
Avg Cost/Claim
$76
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 (D3330 (Endodontic therapy, molar (excluding final restoration))) accounts for 32% of total spending.
$2.5M
3,305 claims
$745.08
$463.40
Endodontic therapy, molar (excluding final restoration)
$2.5M
3,305 claims · 31.6%
$1.1M
7,626 claims
$147.83
$109.42
Extraction, erupted tooth, surgical approach
$1.1M
7,626 claims · 14.5%
$1.1M
16K claims
$69.59
$185.01
Periodic orthodontic treatment visit
$1.1M
16K claims · 13.9%
$408K
7,126 claims
$57.30
$32.07
Comprehensive oral evaluation, new or established patient
$408K
7,126 claims · 5.2%
$387K
670 claims · 5.0%
$358K
425 claims · 4.6%
$219K
7,229 claims
$30.34
$24.34
Periodic oral evaluation, established patient
$219K
7,229 claims · 2.8%
$161K
4,294 claims
$37.44
$71.00
Resin-based composite, two surfaces, posterior
$161K
4,294 claims · 2.1%
Prophylaxis, adult
$149K
5,968 claims · 1.9%
$141K
6,873 claims
$20.49
$14.36
Topical application of fluoride, excluding varnish
$141K
6,873 claims · 1.8%
Prophylaxis, adult cleaning
$140K
2,153 claims · 1.8%
$133K
679 claims · 1.7%
$126K
2,701 claims · 1.6%
$87K
502 claims
$173.96
$187.09
Extraction, impacted tooth, partial bony
$87K
502 claims · 1.1%
$78K
2,691 claims
$28.84
$54.60
Resin-based composite, one surface, posterior
$78K
2,691 claims · 1.0%
$74K
1,328 claims
$55.85
$57.39
Extraction, erupted tooth or exposed root
$74K
1,328 claims · 1.0%
$72K
8,470 claims
$8.49
$10.51
Intraoral periapical radiographic image, first film
$72K
8,470 claims · 0.9%
$58K
574 claims
$101.91
$37.60
Unspecified adjunctive procedure, by report
$58K
574 claims · 0.8%
$57K
247 claims
$230.43
$231.00
Extraction, impacted tooth, complete bony
$57K
247 claims · 0.7%
$53K
139 claims
$382.99
$968.00
Comprehensive orthodontic treatment, adolescent dentition
$53K
139 claims · 0.7%
$52K
5,003 claims
$10.34
$22.54
Bitewings, four radiographic images
$52K
5,003 claims · 0.7%
$48K
101 claims · 0.6%
$43K
950 claims · 0.5%
$41K
7,192 claims
$5.71
$7.33
Intraoral, periapical radiographic image, first film
$41K
7,192 claims · 0.5%
Sealant, per tooth
$37K
2,307 claims · 0.5%
$35K
726 claims
$48.44
$84.26
Resin-based composite, three surfaces, posterior
$35K
726 claims · 0.5%
$30K
42 claims · 0.4%
$24K
1,011 claims · 0.3%
Panoramic radiographic image
$16K
558 claims · 0.2%
$14K
415 claims · 0.2%