Total Paid
$20.7M
$20,679,794
Total Claims
709K
Beneficiaries
484K
1.5 claims/patient
Avg Cost/Claim
$29
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 42 distinct procedure codes. The top code (D1120 (Prophylaxis, adult)) accounts for 13% of total spending.
Prophylaxis, adult
$2.7M
67K claims · 13.2%
$2.5M
41K claims
$62.44
$24.34
Periodic oral evaluation, established patient
$2.5M
41K claims · 12.3%
$2.0M
17K claims
$116.54
$120.85
Prefabricated stainless steel crown, primary tooth
$2.0M
17K claims · 9.4%
$1.6M
25K claims
$64.94
$71.00
Resin-based composite, two surfaces, posterior
$1.6M
25K claims · 7.7%
$1.2M
19K claims
$63.34
$32.07
Comprehensive oral evaluation, new or established patient
$1.2M
19K claims · 5.9%
$1.2M
27K claims
$44.92
$40.52
Nutritional counseling for control of dental disease
$1.2M
27K claims · 5.9%
Sealant, per tooth
$1.2M
41K claims · 5.7%
$978K
62K claims
$15.81
$14.36
Topical application of fluoride, excluding varnish
$978K
62K claims · 4.7%
$915K
23K claims
$39.20
$26.24
Inhalation of nitrous oxide/analgesia, anxiolysis
$915K
23K claims · 4.4%
$874K
212K claims
$4.12
$7.33
Intraoral, periapical radiographic image, first film
$874K
212K claims · 4.2%
$775K
14K claims
$55.34
$57.39
Extraction, erupted tooth or exposed root
$775K
14K claims · 3.7%
$720K
11K claims · 3.5%
$619K
12K claims
$52.60
$54.60
Resin-based composite, one surface, posterior
$619K
12K claims · 3.0%
$393K
6,248 claims
$62.93
$57.30
Oral evaluation for patient under 3 years, counseling
$393K
6,248 claims · 1.9%
$330K
3,400 claims · 1.6%
$326K
28K claims
$11.55
$10.51
Intraoral periapical radiographic image, first film
$326K
28K claims · 1.6%
$270K
24K claims
$11.04
$15.81
Bitewings, two radiographic images
$270K
24K claims · 1.3%
$269K
14K claims
$19.81
$22.54
Bitewings, four radiographic images
$269K
14K claims · 1.3%
$264K
466 claims
$567.29
$107.14
Deep sedation/general anesthesia, each additional 15 min
$264K
466 claims · 1.3%
$251K
17K claims · 1.2%
$208K
21K claims · 1.0%
$194K
2,510 claims
$77.24
$84.26
Resin-based composite, three surfaces, posterior
$194K
2,510 claims · 0.9%
$145K
1,939 claims
$74.93
$66.63
Resin-based composite filling, one surface, anterior
$145K
1,939 claims · 0.7%
$110K
3,541 claims · 0.5%
$109K
7,566 claims · 0.5%
$105K
714 claims · 0.5%
Therapeutic pulpotomy
$84K
859 claims · 0.4%
$72K
697 claims · 0.3%
Panoramic radiographic image
$55K
1,997 claims · 0.3%
$53K
435 claims
$122.50
$90.28
Deep sedation/general anesthesia, first 15 minutes
$53K
435 claims · 0.3%
$43K
946 claims
$45.95
$46.33
Intraoral, complete series of radiographic images
$43K
946 claims · 0.2%
$36K
444 claims · 0.2%
$15K
226 claims · 0.1%
$6K
83 claims
$71.41
$73.58
Resin-based composite filling, two surfaces, anterior
$6K
83 claims · 0.0%
$5K
986 claims
$5.13
$18.12
Topical application of fluoride varnish
$5K
986 claims · 0.0%
$3K
226 claims · 0.0%
$3K
25 claims
$119.00
$109.42
Extraction, erupted tooth, surgical approach
$3K
25 claims · 0.0%
$2K
16 claims · 0.0%
$650
133 claims · 0.0%
$506
281 claims · 0.0%
$0
15 claims · 0.0%
$0
45 claims · 0.0%
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