Provider 1528308202
Total Paid
$7.7M
$7,685,951
Total Claims
160K
Beneficiaries
117K
1.4 claims/patient
Avg Cost/Claim
$48
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 (D2930 (Prefabricated stainless steel crown, primary tooth)) accounts for 35% of total spending.
$2.7M
19K claims
$139.07
$120.85
Prefabricated stainless steel crown, primary tooth
$2.7M
19K claims · 34.8%
$707K
3,401 claims · 9.2%
$697K
13K claims
$55.32
$54.60
Resin-based composite, one surface, posterior
$697K
13K claims · 9.1%
$559K
8,423 claims
$66.31
$71.00
Resin-based composite, two surfaces, posterior
$559K
8,423 claims · 7.3%
$401K
20K claims
$19.73
$14.36
Topical application of fluoride, excluding varnish
$401K
20K claims · 5.2%
Prophylaxis, adult
$393K
18K claims · 5.1%
$378K
14K claims
$27.24
$24.34
Periodic oral evaluation, established patient
$378K
14K claims · 4.9%
Therapeutic pulpotomy
$323K
3,651 claims · 4.2%
$309K
5,710 claims
$54.07
$57.39
Extraction, erupted tooth or exposed root
$309K
5,710 claims · 4.0%
$220K
5,813 claims
$37.81
$32.07
Comprehensive oral evaluation, new or established patient
$220K
5,813 claims · 2.9%
$208K
7,193 claims
$28.92
$37.60
Unspecified adjunctive procedure, by report
$208K
7,193 claims · 2.7%
$138K
1,503 claims
$91.60
$73.58
Resin-based composite filling, two surfaces, anterior
$138K
1,503 claims · 1.8%
$112K
5,536 claims
$20.20
$27.07
Limited oral evaluation, problem focused
$112K
5,536 claims · 1.5%
$87K
8,922 claims
$9.77
$15.81
Bitewings, two radiographic images
$87K
8,922 claims · 1.1%
$87K
1,561 claims · 1.1%
$78K
1,170 claims
$66.89
$66.63
Resin-based composite filling, one surface, anterior
$78K
1,170 claims · 1.0%
Panoramic radiographic image
$63K
1,793 claims · 0.8%
$54K
2,512 claims · 0.7%
Sealant, per tooth
$44K
1,965 claims · 0.6%
$37K
4,918 claims
$7.57
$10.51
Intraoral periapical radiographic image, first film
$37K
4,918 claims · 0.5%
Prophylaxis, adult cleaning
$33K
883 claims · 0.4%
$26K
363 claims
$70.42
$84.26
Resin-based composite, three surfaces, posterior
$26K
363 claims · 0.3%
$22K
4,677 claims · 0.3%
$19K
267 claims · 0.2%
$10K
4,412 claims
$2.19
$7.33
Intraoral, periapical radiographic image, first film
$10K
4,412 claims · 0.1%
$8K
976 claims · 0.1%
$3K
147 claims
$19.05
$26.24
Inhalation of nitrous oxide/analgesia, anxiolysis
$3K
147 claims · 0.0%