Provider 1790939932
Total Paid
$10.0M
$10,042,877
Total Claims
261K
Beneficiaries
225K
1.2 claims/patient
Avg Cost/Claim
$38
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 (D2392 (Resin-based composite, two surfaces, posterior)) accounts for 13% of total spending.
$1.3M
9,733 claims
$133.00
$71.00
Resin-based composite, two surfaces, posterior
$1.3M
9,733 claims · 12.9%
$1.3M
45K claims
$28.76
$24.34
Periodic oral evaluation, established patient
$1.3M
45K claims · 12.8%
Prophylaxis, adult
$1.1M
33K claims · 11.4%
$1.0M
7,670 claims
$133.83
$120.85
Prefabricated stainless steel crown, primary tooth
$1.0M
7,670 claims · 10.2%
$731K
35K claims
$20.94
$18.12
Topical application of fluoride varnish
$731K
35K claims · 7.3%
$643K
16K claims
$38.99
$40.52
Nutritional counseling for control of dental disease
$643K
16K claims · 6.4%
Prophylaxis, adult cleaning
$566K
12K claims · 5.6%
$383K
16K claims · 3.8%
Sealant, per tooth
$377K
13K claims · 3.8%
$292K
3,806 claims
$76.71
$57.39
Extraction, erupted tooth or exposed root
$292K
3,806 claims · 2.9%
Bitewings, two radiographic images
$284K
12K claims · 2.8%
Panoramic radiographic image
$239K
4,095 claims · 2.4%
$235K
1,282 claims
$183.43
$84.26
Resin-based composite, three surfaces, posterior
$235K
1,282 claims · 2.3%
$221K
7,226 claims
$30.54
$26.24
Inhalation of nitrous oxide/analgesia, anxiolysis
$221K
7,226 claims · 2.2%
$209K
12K claims
$18.17
$14.36
Topical application of fluoride, excluding varnish
$209K
12K claims · 2.1%
$198K
4,680 claims · 2.0%
$130K
3,604 claims
$35.95
$27.07
Limited oral evaluation, problem focused
$130K
3,604 claims · 1.3%
$111K
1,595 claims
$69.59
$54.60
Resin-based composite, one surface, posterior
$111K
1,595 claims · 1.1%
$99K
515 claims · 1.0%
$99K
3,174 claims · 1.0%
Therapeutic pulpotomy
$96K
986 claims · 1.0%
Bitewings, four radiographic images
$91K
2,534 claims · 0.9%
$87K
5,089 claims
$17.04
$10.51
Intraoral periapical radiographic image, first film
$87K
5,089 claims · 0.9%
$72K
2,022 claims
$35.56
$32.07
Comprehensive oral evaluation, new or established patient
$72K
2,022 claims · 0.7%
$49K
5,469 claims
$9.05
$7.33
Intraoral, periapical radiographic image, first film
$49K
5,469 claims · 0.5%
$36K
1,034 claims
$34.95
$57.30
Oral evaluation for patient under 3 years, counseling
$36K
1,034 claims · 0.4%
$22K
1,836 claims · 0.2%
$11K
123 claims · 0.1%
$6K
505 claims · 0.1%
$1K
30 claims · 0.0%