Provider 1407023971
Total Paid
$10.8M
$10,778,498
Total Claims
336K
Beneficiaries
281K
1.2 claims/patient
Avg Cost/Claim
$32
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 (D1120 (Prophylaxis, adult)) accounts for 15% of total spending.
Prophylaxis, adult
$1.6M
51K claims · 15.1%
$1.4M
59K claims
$23.08
$24.34
Periodic oral evaluation, established patient
$1.4M
59K claims · 12.7%
$1.1M
16K claims
$70.33
$71.00
Resin-based composite, two surfaces, posterior
$1.1M
16K claims · 10.6%
$1.1M
55K claims
$20.05
$18.12
Topical application of fluoride varnish
$1.1M
55K claims · 10.2%
$1.1M
9,560 claims
$111.10
$120.85
Prefabricated stainless steel crown, primary tooth
$1.1M
9,560 claims · 9.9%
$706K
8,364 claims · 6.6%
Therapeutic pulpotomy
$671K
8,347 claims · 6.2%
$501K
8,383 claims
$59.71
$57.39
Extraction, erupted tooth or exposed root
$501K
8,383 claims · 4.6%
Prophylaxis, adult cleaning
$453K
11K claims · 4.2%
Panoramic radiographic image
$348K
8,630 claims · 3.2%
$316K
19K claims
$16.55
$15.81
Bitewings, two radiographic images
$316K
19K claims · 2.9%
$295K
37K claims
$7.99
$7.33
Intraoral, periapical radiographic image, first film
$295K
37K claims · 2.7%
$205K
3,518 claims
$58.37
$54.60
Resin-based composite, one surface, posterior
$205K
3,518 claims · 1.9%
$186K
16K claims
$11.49
$10.51
Intraoral periapical radiographic image, first film
$186K
16K claims · 1.7%
$182K
6,412 claims
$28.34
$32.07
Comprehensive oral evaluation, new or established patient
$182K
6,412 claims · 1.7%
$137K
5,510 claims
$24.81
$26.24
Inhalation of nitrous oxide/analgesia, anxiolysis
$137K
5,510 claims · 1.3%
$130K
5,167 claims
$25.15
$22.54
Bitewings, four radiographic images
$130K
5,167 claims · 1.2%
Sealant, per tooth
$65K
2,080 claims · 0.6%
$65K
2,983 claims
$21.66
$27.07
Limited oral evaluation, problem focused
$65K
2,983 claims · 0.6%
$60K
748 claims
$79.93
$84.26
Resin-based composite, three surfaces, posterior
$60K
748 claims · 0.6%
$60K
322 claims · 0.6%
$40K
546 claims
$72.48
$73.58
Resin-based composite filling, two surfaces, anterior
$40K
546 claims · 0.4%
$28K
202 claims · 0.3%
$20K
123 claims · 0.2%
$3K
50 claims
$64.60
$66.63
Resin-based composite filling, one surface, anterior
$3K
50 claims · 0.0%
$103
539 claims · 0.0%
$0
119 claims · 0.0%