Provider 1811084387
Total Paid
$10.3M
$10,259,580
Total Claims
183K
Beneficiaries
159K
1.2 claims/patient
Avg Cost/Claim
$56
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 (D8670 (Periodic orthodontic treatment visit)) accounts for 11% of total spending.
$1.1M
4,297 claims
$258.46
$185.01
Periodic orthodontic treatment visit
$1.1M
4,297 claims · 10.8%
Prophylaxis, adult
$980K
19K claims · 9.6%
$856K
1,237 claims
$692.01
$509.58
Crown, porcelain/ceramic substrate
$856K
1,237 claims · 8.3%
Sealant, per tooth
$783K
19K claims · 7.6%
$753K
26K claims
$29.02
$24.34
Periodic oral evaluation, established patient
$753K
26K claims · 7.3%
$694K
26K claims
$26.50
$18.12
Topical application of fluoride varnish
$694K
26K claims · 6.8%
Prophylaxis, adult cleaning
$620K
9,409 claims · 6.0%
$599K
6,988 claims
$85.74
$54.60
Resin-based composite, one surface, posterior
$599K
6,988 claims · 5.8%
$538K
5,156 claims
$104.44
$71.00
Resin-based composite, two surfaces, posterior
$538K
5,156 claims · 5.2%
$522K
2,658 claims
$196.44
$120.85
Prefabricated stainless steel crown, primary tooth
$522K
2,658 claims · 5.1%
Bitewings, four radiographic images
$507K
12K claims · 4.9%
Bitewings, two radiographic images
$327K
11K claims · 3.2%
$313K
261 claims
$1,199.93
$968.00
Comprehensive orthodontic treatment, adolescent dentition
$313K
261 claims · 3.1%
Panoramic radiographic image
$197K
5,220 claims · 1.9%
$192K
1,946 claims
$98.82
$57.39
Extraction, erupted tooth or exposed root
$192K
1,946 claims · 1.9%
$159K
8,583 claims
$18.52
$10.51
Intraoral periapical radiographic image, first film
$159K
8,583 claims · 1.5%
$144K
2,894 claims
$49.64
$32.07
Comprehensive oral evaluation, new or established patient
$144K
2,894 claims · 1.4%
$127K
1,648 claims · 1.2%
$111K
2,648 claims
$41.98
$27.07
Limited oral evaluation, problem focused
$111K
2,648 claims · 1.1%
$103K
357 claims · 1.0%
$85K
5,664 claims
$15.04
$7.33
Intraoral, periapical radiographic image, first film
$85K
5,664 claims · 0.8%
$81K
635 claims · 0.8%
$76K
593 claims · 0.7%
$64K
700 claims · 0.6%
$49K
1,333 claims · 0.5%
$45K
78 claims
$574.01
$476.00
Crown, porcelain fused to predominantly base metal
$45K
78 claims · 0.4%
$42K
404 claims
$103.47
$84.26
Resin-based composite, three surfaces, posterior
$42K
404 claims · 0.4%
$36K
533 claims
$67.65
$46.33
Intraoral, complete series of radiographic images
$36K
533 claims · 0.4%
$30K
154 claims · 0.3%
$29K
79 claims
$372.75
$231.00
Extraction, impacted tooth, complete bony
$29K
79 claims · 0.3%