Provider 1891158861
Total Paid
$8.7M
$8,698,234
Total Claims
436K
Beneficiaries
335K
1.3 claims/patient
Avg Cost/Claim
$20
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 29 distinct procedure codes. The top code (D0120 (Periodic oral evaluation, established patient)) accounts for 12% of total spending.
$1.1M
40K claims
$26.49
$24.34
Periodic oral evaluation, established patient
$1.1M
40K claims · 12.2%
Prophylaxis, adult
$1.0M
44K claims · 11.8%
$901K
46K claims
$19.50
$14.36
Topical application of fluoride, excluding varnish
$901K
46K claims · 10.4%
$666K
10K claims
$66.09
$71.00
Resin-based composite, two surfaces, posterior
$666K
10K claims · 7.7%
$646K
4,262 claims
$151.57
$120.85
Prefabricated stainless steel crown, primary tooth
$646K
4,262 claims · 7.4%
$619K
14K claims · 7.1%
$489K
8,860 claims
$55.24
$54.60
Resin-based composite, one surface, posterior
$489K
8,860 claims · 5.6%
$374K
46K claims
$8.05
$10.51
Intraoral periapical radiographic image, first film
$374K
46K claims · 4.3%
Sealant, per tooth
$373K
16K claims · 4.3%
$337K
11K claims
$30.02
$37.60
Unspecified adjunctive procedure, by report
$337K
11K claims · 3.9%
$318K
8,151 claims
$39.02
$32.07
Comprehensive oral evaluation, new or established patient
$318K
8,151 claims · 3.7%
$302K
31K claims
$9.88
$15.81
Bitewings, two radiographic images
$302K
31K claims · 3.5%
$298K
14K claims
$21.74
$26.24
Inhalation of nitrous oxide/analgesia, anxiolysis
$298K
14K claims · 3.4%
Panoramic radiographic image
$266K
8,618 claims · 3.1%
$261K
113K claims
$2.31
$7.33
Intraoral, periapical radiographic image, first film
$261K
113K claims · 3.0%
$239K
4,272 claims
$56.04
$57.39
Extraction, erupted tooth or exposed root
$239K
4,272 claims · 2.8%
Prophylaxis, adult cleaning
$148K
3,572 claims · 1.7%
Therapeutic pulpotomy
$103K
1,046 claims · 1.2%
$88K
4,207 claims
$20.96
$27.07
Limited oral evaluation, problem focused
$88K
4,207 claims · 1.0%
$85K
306 claims · 1.0%
$64K
4,847 claims · 0.7%
$15K
203 claims
$74.19
$84.26
Resin-based composite, three surfaces, posterior
$15K
203 claims · 0.2%
$6K
1,516 claims · 0.1%
Bitewings, four radiographic images
$3K
325 claims · 0.0%
$3K
104 claims · 0.0%
$2K
23 claims
$83.24
$66.63
Resin-based composite filling, one surface, anterior
$2K
23 claims · 0.0%
$2K
24 claims · 0.0%
$48
12 claims · 0.0%
$18
42 claims · 0.0%