Provider 1720138464
Total Paid
$7.6M
$7,550,037
Total Claims
167K
Beneficiaries
149K
1.1 claims/patient
Avg Cost/Claim
$45
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 (D2750 (Crown, porcelain fused to high noble metal)) accounts for 17% of total spending.
$1.3M
2,257 claims
$563.45
$445.23
Crown, porcelain fused to high noble metal
$1.3M
2,257 claims · 16.8%
$1.2M
1,701 claims
$690.49
$463.40
Endodontic therapy, molar (excluding final restoration)
$1.2M
1,701 claims · 15.6%
Prophylaxis, adult cleaning
$889K
20K claims · 11.8%
$747K
12K claims
$62.62
$71.00
Resin-based composite, two surfaces, posterior
$747K
12K claims · 9.9%
$563K
943 claims · 7.5%
$379K
6,962 claims
$54.42
$46.33
Intraoral, complete series of radiographic images
$379K
6,962 claims · 5.0%
$368K
21K claims
$17.92
$24.34
Periodic oral evaluation, established patient
$368K
21K claims · 4.9%
$289K
3,686 claims
$78.30
$84.26
Resin-based composite, three surfaces, posterior
$289K
3,686 claims · 3.8%
$272K
1,995 claims · 3.6%
$252K
18K claims
$13.76
$14.36
Topical application of fluoride, excluding varnish
$252K
18K claims · 3.3%
$217K
5,201 claims
$41.68
$54.60
Resin-based composite, one surface, posterior
$217K
5,201 claims · 2.9%
$189K
2,879 claims
$65.71
$70.00
Periodontal scaling, per quadrant
$189K
2,879 claims · 2.5%
$160K
5,546 claims
$28.82
$32.07
Comprehensive oral evaluation, new or established patient
$160K
5,546 claims · 2.1%
$155K
10K claims
$15.43
$22.54
Bitewings, four radiographic images
$155K
10K claims · 2.1%
$149K
20K claims
$7.57
$10.51
Intraoral periapical radiographic image, first film
$149K
20K claims · 2.0%
Prophylaxis, adult
$132K
5,285 claims · 1.7%
$97K
23K claims
$4.11
$7.33
Intraoral, periapical radiographic image, first film
$97K
23K claims · 1.3%
$47K
85 claims
$552.57
$509.58
Crown, porcelain/ceramic substrate
$47K
85 claims · 0.6%
$42K
85 claims · 0.5%
$40K
2,462 claims
$16.24
$27.07
Limited oral evaluation, problem focused
$40K
2,462 claims · 0.5%
$26K
1,997 claims
$12.84
$15.81
Bitewings, two radiographic images
$26K
1,997 claims · 0.3%
$21K
224 claims · 0.3%
$17K
210 claims · 0.2%
$12K
245 claims · 0.2%
$10K
156 claims
$64.47
$73.58
Resin-based composite filling, two surfaces, anterior
$10K
156 claims · 0.1%
$8K
158 claims
$53.23
$66.63
Resin-based composite filling, one surface, anterior
$8K
158 claims · 0.1%
$5K
197 claims · 0.1%
$4K
12 claims · 0.0%
$3K
31 claims · 0.0%
$3K
33 claims · 0.0%