Provider 1427415116
Total Paid
$15.5M
$15,536,058
Total Claims
283K
Beneficiaries
146K
1.9 claims/patient
Avg Cost/Claim
$55
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 (D2930 (Prefabricated stainless steel crown, primary tooth)) accounts for 53% of total spending.
$8.3M
59K claims
$140.58
$120.85
Prefabricated stainless steel crown, primary tooth
$8.3M
59K claims · 53.4%
Therapeutic pulpotomy
$1.3M
17K claims · 8.6%
$1.1M
7,692 claims · 7.0%
$864K
15K claims
$59.25
$57.39
Extraction, erupted tooth or exposed root
$864K
15K claims · 5.6%
$667K
9,282 claims
$71.86
$54.60
Resin-based composite, one surface, posterior
$667K
9,282 claims · 4.3%
$539K
8,625 claims
$62.53
$46.33
Intraoral, complete series of radiographic images
$539K
8,625 claims · 3.5%
$456K
14K claims
$31.87
$32.07
Comprehensive oral evaluation, new or established patient
$456K
14K claims · 2.9%
Sealant, per tooth
$429K
18K claims · 2.8%
$291K
44K claims
$6.61
$7.33
Intraoral, periapical radiographic image, first film
$291K
44K claims · 1.9%
$287K
7,301 claims
$39.28
$107.14
Deep sedation/general anesthesia, each additional 15 min
$287K
7,301 claims · 1.8%
$277K
2,947 claims
$93.92
$71.00
Resin-based composite, two surfaces, posterior
$277K
2,947 claims · 1.8%
$196K
3,682 claims
$53.28
$90.28
Deep sedation/general anesthesia, first 15 minutes
$196K
3,682 claims · 1.3%
$178K
11K claims
$16.69
$27.07
Limited oral evaluation, problem focused
$178K
11K claims · 1.1%
$106K
1,492 claims
$71.30
$66.63
Resin-based composite filling, one surface, anterior
$106K
1,492 claims · 0.7%
$93K
8,683 claims · 0.6%
$92K
12K claims
$7.88
$10.51
Intraoral periapical radiographic image, first film
$92K
12K claims · 0.6%
$66K
6,126 claims · 0.4%
$65K
5,470 claims
$11.93
$15.81
Bitewings, two radiographic images
$65K
5,470 claims · 0.4%
$52K
1,755 claims · 0.3%
$47K
178 claims
$265.98
$231.00
Extraction, impacted tooth, complete bony
$47K
178 claims · 0.3%
Panoramic radiographic image
$43K
788 claims · 0.3%
$32K
223 claims · 0.2%
$8K
606 claims · 0.1%
$7K
499 claims · 0.0%
$7K
98 claims · 0.0%
$3K
291 claims · 0.0%
$2K
103 claims
$14.79
$22.54
Bitewings, four radiographic images
$2K
103 claims · 0.0%
$488
14 claims · 0.0%
$435
25 claims · 0.0%
$147
18 claims · 0.0%