Provider 1619688751
Total Paid
$8.6M
$8,578,312
Total Claims
160K
Beneficiaries
123K
1.3 claims/patient
Avg Cost/Claim
$54
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 (D1110 (Prophylaxis, adult cleaning)) accounts for 8% of total spending.
Prophylaxis, adult cleaning
$663K
10K claims · 7.7%
$593K
6,039 claims
$98.21
$71.00
Resin-based composite, two surfaces, posterior
$593K
6,039 claims · 6.9%
Panoramic radiographic image
$550K
6,333 claims · 6.4%
$530K
4,960 claims
$106.94
$57.39
Extraction, erupted tooth or exposed root
$530K
4,960 claims · 6.2%
$499K
15K claims
$33.47
$18.12
Topical application of fluoride varnish
$499K
15K claims · 5.8%
$443K
5,960 claims
$74.36
$54.60
Resin-based composite, one surface, posterior
$443K
5,960 claims · 5.2%
Bitewings, four radiographic images
$435K
9,936 claims · 5.1%
Periodontal scaling, per quadrant
$382K
1,859 claims · 4.5%
$367K
9,728 claims
$37.72
$24.34
Periodic oral evaluation, established patient
$367K
9,728 claims · 4.3%
$337K
7,951 claims
$42.34
$27.07
Limited oral evaluation, problem focused
$337K
7,951 claims · 3.9%
Sealant, per tooth
$335K
8,306 claims · 3.9%
$272K
23K claims
$11.94
$7.33
Intraoral, periapical radiographic image, first film
$272K
23K claims · 3.2%
$254K
5,438 claims
$46.70
$32.07
Comprehensive oral evaluation, new or established patient
$254K
5,438 claims · 3.0%
$254K
2,106 claims
$120.52
$84.26
Resin-based composite, three surfaces, posterior
$254K
2,106 claims · 3.0%
$251K
1,690 claims
$148.65
$109.42
Extraction, erupted tooth, surgical approach
$251K
1,690 claims · 2.9%
$247K
6,931 claims · 2.9%
$225K
13K claims
$17.16
$10.51
Intraoral periapical radiographic image, first film
$225K
13K claims · 2.6%
Prophylaxis, adult
$207K
4,653 claims · 2.4%
$149K
1,320 claims
$112.87
$73.58
Resin-based composite filling, two surfaces, anterior
$149K
1,320 claims · 1.7%
$146K
997 claims · 1.7%
$131K
143 claims · 1.5%
$115K
822 claims · 1.3%
Bitewings, two radiographic images
$114K
2,886 claims · 1.3%
$111K
1,036 claims
$107.53
$66.00
Amalgam, two surfaces, primary or permanent
$111K
1,036 claims · 1.3%
$109K
2,913 claims · 1.3%
$108K
97 claims · 1.3%
$108K
1,240 claims
$86.76
$66.63
Resin-based composite filling, one surface, anterior
$108K
1,240 claims · 1.3%
$78K
667 claims · 0.9%
Amalgam filling, three surfaces
$73K
562 claims · 0.9%
$61K
58 claims · 0.7%