Provider 1336368182
Total Paid
$10.4M
$10,390,364
Total Claims
99K
Beneficiaries
84K
1.2 claims/patient
Avg Cost/Claim
$105
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 27 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 87% of total spending.
$9.1M
39K claims
$231.89
$121.16
Clinic visit/encounter, all-inclusive
$9.1M
39K claims · 87.3%
$168K
4,145 claims
$40.47
$57.39
Extraction, erupted tooth or exposed root
$168K
4,145 claims · 1.6%
$167K
6,775 claims
$24.72
$27.07
Limited oral evaluation, problem focused
$167K
6,775 claims · 1.6%
$135K
2,194 claims
$61.71
$71.00
Resin-based composite, two surfaces, posterior
$135K
2,194 claims · 1.3%
$134K
4,062 claims
$32.97
$32.07
Comprehensive oral evaluation, new or established patient
$134K
4,062 claims · 1.3%
$127K
3,820 claims
$33.37
$70.00
Periodontal scaling, per quadrant
$127K
3,820 claims · 1.2%
$102K
2,883 claims
$35.53
$46.33
Intraoral, complete series of radiographic images
$102K
2,883 claims · 1.0%
$82K
9,253 claims
$8.87
$10.51
Intraoral periapical radiographic image, first film
$82K
9,253 claims · 0.8%
Prophylaxis, adult cleaning
$81K
2,208 claims · 0.8%
$74K
2,870 claims
$25.93
$24.34
Periodic oral evaluation, established patient
$74K
2,870 claims · 0.7%
$57K
3,697 claims
$15.35
$18.12
Topical application of fluoride varnish
$57K
3,697 claims · 0.5%
$30K
1,021 claims · 0.3%
$29K
569 claims
$50.38
$54.60
Resin-based composite, one surface, posterior
$29K
569 claims · 0.3%
$26K
2,210 claims
$11.57
$22.54
Bitewings, four radiographic images
$26K
2,210 claims · 0.2%
$23K
319 claims
$72.69
$84.26
Resin-based composite, three surfaces, posterior
$23K
319 claims · 0.2%
$18K
8,524 claims
$2.11
$7.33
Intraoral, periapical radiographic image, first film
$18K
8,524 claims · 0.2%
$17K
1,221 claims · 0.2%
Panoramic radiographic image
$16K
584 claims · 0.2%
$16K
2,245 claims · 0.2%
$15K
1,230 claims · 0.1%
$1K
15 claims
$89.38
$73.58
Resin-based composite filling, two surfaces, anterior
$1K
15 claims · 0.0%
$766
13 claims
$58.90
$66.63
Resin-based composite filling, one surface, anterior
$766
13 claims · 0.0%
$690
70 claims · 0.0%
Prophylaxis, adult
$597
39 claims · 0.0%
Bitewings, two radiographic images
$98
12 claims · 0.0%
$0
39 claims · 0.0%
$0
136 claims · 0.0%