Provider 1912356411
Total Paid
$9.8M
$9,845,060
Total Claims
361K
Beneficiaries
293K
1.2 claims/patient
Avg Cost/Claim
$27
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 15% of total spending.
$1.4M
9,487 claims
$151.92
$120.85
Prefabricated stainless steel crown, primary tooth
$1.4M
9,487 claims · 14.6%
$1.4M
51K claims
$26.91
$24.34
Periodic oral evaluation, established patient
$1.4M
51K claims · 14.0%
Prophylaxis, adult
$1.2M
50K claims · 11.8%
$913K
43K claims
$21.21
$18.12
Topical application of fluoride varnish
$913K
43K claims · 9.3%
$903K
13K claims
$67.50
$71.00
Resin-based composite, two surfaces, posterior
$903K
13K claims · 9.2%
Sealant, per tooth
$664K
29K claims · 6.7%
$354K
12K claims
$29.43
$37.60
Unspecified adjunctive procedure, by report
$354K
12K claims · 3.6%
$350K
6,652 claims
$52.65
$57.39
Extraction, erupted tooth or exposed root
$350K
6,652 claims · 3.6%
$327K
6,085 claims
$53.68
$54.60
Resin-based composite, one surface, posterior
$327K
6,085 claims · 3.3%
Prophylaxis, adult cleaning
$314K
8,299 claims · 3.2%
$300K
7,609 claims
$39.41
$32.07
Comprehensive oral evaluation, new or established patient
$300K
7,609 claims · 3.0%
$289K
13K claims
$21.78
$26.24
Inhalation of nitrous oxide/analgesia, anxiolysis
$289K
13K claims · 2.9%
$184K
19K claims
$9.51
$15.81
Bitewings, two radiographic images
$184K
19K claims · 1.9%
$184K
12K claims
$15.87
$14.36
Topical application of fluoride, excluding varnish
$184K
12K claims · 1.9%
Panoramic radiographic image
$166K
4,440 claims · 1.7%
$163K
7,828 claims
$20.88
$27.07
Limited oral evaluation, problem focused
$163K
7,828 claims · 1.7%
$129K
17K claims
$7.57
$10.51
Intraoral periapical radiographic image, first film
$129K
17K claims · 1.3%
$110K
404 claims · 1.1%
$74K
5,481 claims
$13.45
$22.54
Bitewings, four radiographic images
$74K
5,481 claims · 0.7%
$62K
8,008 claims · 0.6%
$60K
5,455 claims · 0.6%
$54K
698 claims
$77.83
$84.26
Resin-based composite, three surfaces, posterior
$54K
698 claims · 0.6%
$45K
21K claims
$2.17
$7.33
Intraoral, periapical radiographic image, first film
$45K
21K claims · 0.5%
$42K
494 claims · 0.4%
Therapeutic pulpotomy
$35K
374 claims · 0.4%
$30K
461 claims
$65.69
$66.00
Amalgam, two surfaces, primary or permanent
$30K
461 claims · 0.3%
$25K
626 claims · 0.3%
$21K
248 claims · 0.2%
$20K
220 claims · 0.2%
$17K
98 claims · 0.2%