Provider 1851450993
Total Paid
$15.4M
$15,377,189
Total Claims
476K
Beneficiaries
354K
1.3 claims/patient
Avg Cost/Claim
$32
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 (D2930 (Prefabricated stainless steel crown, primary tooth)) accounts for 16% of total spending.
$2.4M
15K claims
$156.36
$120.85
Prefabricated stainless steel crown, primary tooth
$2.4M
15K claims · 15.7%
$2.4M
11K claims
$207.09
$107.14
Deep sedation/general anesthesia, each additional 15 min
$2.4M
11K claims · 15.4%
$1.4M
22K claims
$64.19
$57.39
Extraction, erupted tooth or exposed root
$1.4M
22K claims · 9.3%
$976K
14K claims
$71.60
$66.00
Amalgam, two surfaces, primary or permanent
$976K
14K claims · 6.4%
$725K
82K claims
$8.90
$7.33
Intraoral, periapical radiographic image, first film
$725K
82K claims · 4.7%
$663K
4,231 claims
$156.78
$90.28
Deep sedation/general anesthesia, first 15 minutes
$663K
4,231 claims · 4.3%
Therapeutic pulpotomy
$620K
6,261 claims · 4.0%
$575K
7,168 claims
$80.16
$109.42
Extraction, erupted tooth, surgical approach
$575K
7,168 claims · 3.7%
$499K
11K claims · 3.2%
$409K
19K claims
$21.24
$24.34
Periodic oral evaluation, established patient
$409K
19K claims · 2.7%
Prophylaxis, adult
$385K
23K claims · 2.5%
$348K
12K claims
$29.23
$32.07
Comprehensive oral evaluation, new or established patient
$348K
12K claims · 2.3%
$330K
1,830 claims · 2.1%
$329K
2,651 claims · 2.1%
$319K
4,447 claims
$71.79
$37.60
Unspecified adjunctive procedure, by report
$319K
4,447 claims · 2.1%
$294K
15K claims
$19.46
$18.12
Topical application of fluoride varnish
$294K
15K claims · 1.9%
$257K
12K claims
$21.15
$71.00
Resin-based composite, two surfaces, posterior
$257K
12K claims · 1.7%
$223K
38K claims
$5.87
$10.51
Intraoral periapical radiographic image, first film
$223K
38K claims · 1.5%
$215K
3,473 claims
$61.91
$52.77
Amalgam, one surface, primary or permanent
$215K
3,473 claims · 1.4%
Sealant, per tooth
$196K
10K claims · 1.3%
$158K
18K claims
$8.89
$15.81
Bitewings, two radiographic images
$158K
18K claims · 1.0%
Panoramic radiographic image
$152K
10K claims · 1.0%
Amalgam filling, three surfaces
$150K
1,723 claims · 1.0%
$149K
1,873 claims
$79.34
$66.63
Resin-based composite filling, one surface, anterior
$149K
1,873 claims · 1.0%
$147K
20K claims
$7.44
$40.52
Nutritional counseling for control of dental disease
$147K
20K claims · 1.0%
$131K
6,911 claims
$18.94
$46.33
Intraoral, complete series of radiographic images
$131K
6,911 claims · 0.9%
$123K
7,537 claims
$16.30
$54.60
Resin-based composite, one surface, posterior
$123K
7,537 claims · 0.8%
$121K
1,588 claims
$76.25
$73.58
Resin-based composite filling, two surfaces, anterior
$121K
1,588 claims · 0.8%
Prophylaxis, adult cleaning
$106K
3,819 claims · 0.7%
$102K
504 claims
$201.48
$187.09
Extraction, impacted tooth, partial bony
$102K
504 claims · 0.7%