Provider 1871604371
Total Paid
$12.4M
$12,368,971
Total Claims
471K
Beneficiaries
438K
1.1 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 (D1120 (Prophylaxis, adult)) accounts for 18% of total spending.
Prophylaxis, adult
$2.3M
54K claims · 18.2%
$1.5M
57K claims
$27.16
$24.34
Periodic oral evaluation, established patient
$1.5M
57K claims · 12.5%
$1.5M
18K claims
$80.89
$71.00
Resin-based composite, two surfaces, posterior
$1.5M
18K claims · 11.7%
Sealant, per tooth
$1.4M
30K claims · 11.6%
$1.1M
37K claims
$30.03
$18.12
Topical application of fluoride varnish
$1.1M
37K claims · 9.0%
Prophylaxis, adult cleaning
$677K
13K claims · 5.5%
$661K
40K claims
$16.38
$15.81
Bitewings, two radiographic images
$661K
40K claims · 5.3%
$639K
4,922 claims
$129.89
$120.85
Prefabricated stainless steel crown, primary tooth
$639K
4,922 claims · 5.2%
$423K
7,618 claims
$55.50
$54.60
Resin-based composite, one surface, posterior
$423K
7,618 claims · 3.4%
$385K
30K claims
$12.92
$14.36
Topical application of fluoride, excluding varnish
$385K
30K claims · 3.1%
$336K
13K claims
$26.53
$22.54
Bitewings, four radiographic images
$336K
13K claims · 2.7%
$309K
9,986 claims
$30.99
$32.07
Comprehensive oral evaluation, new or established patient
$309K
9,986 claims · 2.5%
$309K
23K claims
$13.28
$10.51
Intraoral periapical radiographic image, first film
$309K
23K claims · 2.5%
$298K
4,797 claims
$62.20
$57.39
Extraction, erupted tooth or exposed root
$298K
4,797 claims · 2.4%
$127K
13K claims
$9.94
$7.33
Intraoral, periapical radiographic image, first film
$127K
13K claims · 1.0%
$84K
849 claims
$98.95
$84.26
Resin-based composite, three surfaces, posterior
$84K
849 claims · 0.7%
Therapeutic pulpotomy
$70K
691 claims · 0.6%
$49K
1,979 claims · 0.4%
$33K
202 claims · 0.3%
$30K
1,208 claims · 0.2%
$27K
1,781 claims
$15.31
$26.24
Inhalation of nitrous oxide/analgesia, anxiolysis
$27K
1,781 claims · 0.2%
$26K
1,700 claims · 0.2%
$20K
431 claims
$45.24
$37.60
Unspecified adjunctive procedure, by report
$20K
431 claims · 0.2%
$10K
630 claims
$15.38
$27.07
Limited oral evaluation, problem focused
$10K
630 claims · 0.1%
$9K
119 claims · 0.1%
$9K
79 claims · 0.1%
$8K
163 claims · 0.1%
$8K
22K claims · 0.1%
$8K
246 claims
$32.73
$57.30
Oral evaluation for patient under 3 years, counseling
$8K
246 claims · 0.1%
$7K
354 claims · 0.1%