Provider 1881079267
Total Paid
$14.0M
$13,999,614
Total Claims
399K
Beneficiaries
322K
1.2 claims/patient
Avg Cost/Claim
$35
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 14% of total spending.
$2.0M
14K claims
$143.67
$120.85
Prefabricated stainless steel crown, primary tooth
$2.0M
14K claims · 14.0%
$1.9M
19K claims
$96.26
$71.00
Resin-based composite, two surfaces, posterior
$1.9M
19K claims · 13.3%
$1.3M
9,086 claims
$138.83
$57.30
Oral evaluation for patient under 3 years, counseling
$1.3M
9,086 claims · 9.0%
$947K
34K claims
$28.11
$24.34
Periodic oral evaluation, established patient
$947K
34K claims · 6.8%
$906K
12K claims
$74.39
$54.60
Resin-based composite, one surface, posterior
$906K
12K claims · 6.5%
Prophylaxis, adult
$868K
24K claims · 6.2%
Sealant, per tooth
$804K
30K claims · 5.7%
$682K
2,463 claims
$276.81
$231.00
Extraction, impacted tooth, complete bony
$682K
2,463 claims · 4.9%
Prophylaxis, adult cleaning
$567K
11K claims · 4.1%
$563K
54K claims
$10.50
$7.33
Intraoral, periapical radiographic image, first film
$563K
54K claims · 4.0%
$515K
36K claims
$14.29
$14.36
Topical application of fluoride, excluding varnish
$515K
36K claims · 3.7%
$424K
37K claims
$11.33
$10.51
Intraoral periapical radiographic image, first film
$424K
37K claims · 3.0%
$394K
3,396 claims · 2.8%
Bitewings, four radiographic images
$389K
12K claims · 2.8%
Bitewings, two radiographic images
$342K
16K claims · 2.4%
$338K
13K claims
$26.15
$26.24
Inhalation of nitrous oxide/analgesia, anxiolysis
$338K
13K claims · 2.4%
Therapeutic pulpotomy
$260K
3,180 claims · 1.9%
$209K
1,477 claims · 1.5%
$181K
1,860 claims
$97.52
$84.26
Resin-based composite, three surfaces, posterior
$181K
1,860 claims · 1.3%
$98K
1,556 claims
$62.90
$46.33
Intraoral, complete series of radiographic images
$98K
1,556 claims · 0.7%
$82K
2,463 claims
$33.09
$32.07
Comprehensive oral evaluation, new or established patient
$82K
2,463 claims · 0.6%
Panoramic radiographic image
$64K
2,453 claims · 0.5%
$63K
4,408 claims · 0.5%
$41K
792 claims
$51.51
$107.14
Deep sedation/general anesthesia, each additional 15 min
$41K
792 claims · 0.3%
$32K
1,882 claims
$17.23
$27.07
Limited oral evaluation, problem focused
$32K
1,882 claims · 0.2%
$31K
572 claims
$54.33
$57.39
Extraction, erupted tooth or exposed root
$31K
572 claims · 0.2%
$26K
361 claims
$70.95
$66.63
Resin-based composite filling, one surface, anterior
$26K
361 claims · 0.2%
$24K
2,263 claims · 0.2%
$24K
344 claims
$69.35
$90.28
Deep sedation/general anesthesia, first 15 minutes
$24K
344 claims · 0.2%
$22K
183 claims · 0.2%