Provider 1720457500
Total Paid
$18.3M
$18,345,192
Total Claims
693K
Beneficiaries
437K
1.6 claims/patient
Avg Cost/Claim
$26
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 (D0120 (Periodic oral evaluation, established patient)) accounts for 15% of total spending.
$2.8M
49K claims
$57.80
$24.34
Periodic oral evaluation, established patient
$2.8M
49K claims · 15.5%
Prophylaxis, adult
$2.5M
63K claims · 13.7%
$1.3M
19K claims
$66.84
$66.00
Amalgam, two surfaces, primary or permanent
$1.3M
19K claims · 6.9%
$1.1M
236K claims
$4.49
$7.33
Intraoral, periapical radiographic image, first film
$1.1M
236K claims · 5.8%
Sealant, per tooth
$1.0M
36K claims · 5.6%
$1.0M
23K claims
$45.32
$40.52
Nutritional counseling for control of dental disease
$1.0M
23K claims · 5.6%
$964K
8,370 claims
$115.22
$120.85
Prefabricated stainless steel crown, primary tooth
$964K
8,370 claims · 5.3%
$882K
16K claims
$54.24
$52.77
Amalgam, one surface, primary or permanent
$882K
16K claims · 4.8%
$845K
15K claims
$56.99
$57.39
Extraction, erupted tooth or exposed root
$845K
15K claims · 4.6%
Therapeutic pulpotomy
$743K
7,662 claims · 4.1%
$724K
12K claims · 3.9%
$697K
42K claims
$16.55
$18.12
Topical application of fluoride varnish
$697K
42K claims · 3.8%
$670K
17K claims
$39.13
$26.24
Inhalation of nitrous oxide/analgesia, anxiolysis
$670K
17K claims · 3.7%
$502K
8,008 claims
$62.68
$32.07
Comprehensive oral evaluation, new or established patient
$502K
8,008 claims · 2.7%
$405K
6,613 claims
$61.23
$57.30
Oral evaluation for patient under 3 years, counseling
$405K
6,613 claims · 2.2%
$376K
32K claims
$11.88
$10.51
Intraoral periapical radiographic image, first film
$376K
32K claims · 2.1%
$307K
21K claims · 1.7%
$306K
26K claims
$11.86
$15.81
Bitewings, two radiographic images
$306K
26K claims · 1.7%
$282K
24K claims · 1.5%
$252K
21K claims
$11.77
$14.36
Topical application of fluoride, excluding varnish
$252K
21K claims · 1.4%
$187K
2,529 claims
$74.00
$66.63
Resin-based composite filling, one surface, anterior
$187K
2,529 claims · 1.0%
$129K
1,919 claims
$66.99
$71.00
Resin-based composite, two surfaces, posterior
$129K
1,919 claims · 0.7%
$125K
1,577 claims
$79.03
$78.55
Amalgam filling, three surfaces
$125K
1,577 claims · 0.7%
$81K
1,777 claims
$45.34
$46.33
Intraoral, complete series of radiographic images
$81K
1,777 claims · 0.4%
$63K
1,172 claims
$54.18
$54.60
Resin-based composite, one surface, posterior
$63K
1,172 claims · 0.3%
$23K
143 claims · 0.1%
$23K
720 claims · 0.1%
$15K
1,001 claims · 0.1%
$9K
79 claims
$112.97
$109.42
Extraction, erupted tooth, surgical approach
$9K
79 claims · 0.0%
$5K
59 claims
$78.37
$73.58
Resin-based composite filling, two surfaces, anterior
$5K
59 claims · 0.0%