Provider 1942399324
Total Paid
$17.5M
$17,515,364
Total Claims
536K
Beneficiaries
433K
1.2 claims/patient
Avg Cost/Claim
$33
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 (D2929) accounts for 17% of total spending.
$2.9M
13K claims · 16.5%
$2.3M
33K claims
$69.56
$71.00
Resin-based composite, two surfaces, posterior
$2.3M
33K claims · 13.0%
$2.0M
76K claims
$26.01
$24.34
Periodic oral evaluation, established patient
$2.0M
76K claims · 11.3%
Prophylaxis, adult
$1.6M
69K claims · 8.9%
$1.5M
81K claims
$18.98
$18.12
Topical application of fluoride varnish
$1.5M
81K claims · 8.8%
$853K
16K claims
$54.88
$57.39
Extraction, erupted tooth or exposed root
$853K
16K claims · 4.9%
$704K
33K claims
$21.26
$26.24
Inhalation of nitrous oxide/analgesia, anxiolysis
$704K
33K claims · 4.0%
Therapeutic pulpotomy
$639K
6,694 claims · 3.6%
$634K
22K claims
$28.71
$37.60
Unspecified adjunctive procedure, by report
$634K
22K claims · 3.6%
Sealant, per tooth
$603K
27K claims · 3.4%
$554K
7,308 claims
$75.85
$84.26
Resin-based composite, three surfaces, posterior
$554K
7,308 claims · 3.2%
$440K
7,994 claims
$55.01
$54.60
Resin-based composite, one surface, posterior
$440K
7,994 claims · 2.5%
Prophylaxis, adult cleaning
$431K
12K claims · 2.5%
$390K
9,760 claims
$39.98
$32.07
Comprehensive oral evaluation, new or established patient
$390K
9,760 claims · 2.2%
$320K
3,545 claims · 1.8%
$261K
27K claims
$9.71
$15.81
Bitewings, two radiographic images
$261K
27K claims · 1.5%
Panoramic radiographic image
$260K
7,228 claims · 1.5%
$165K
12K claims
$13.75
$22.54
Bitewings, four radiographic images
$165K
12K claims · 0.9%
$154K
7,481 claims
$20.59
$27.07
Limited oral evaluation, problem focused
$154K
7,481 claims · 0.9%
$143K
2,168 claims · 0.8%
$119K
16K claims
$7.67
$10.51
Intraoral periapical radiographic image, first film
$119K
16K claims · 0.7%
$110K
8,542 claims · 0.6%
$103K
1,755 claims
$58.91
$66.63
Resin-based composite filling, one surface, anterior
$103K
1,755 claims · 0.6%
$98K
931 claims
$104.97
$120.85
Prefabricated stainless steel crown, primary tooth
$98K
931 claims · 0.6%
$86K
2,101 claims · 0.5%
$84K
12K claims · 0.5%
$41K
18K claims
$2.31
$7.33
Intraoral, periapical radiographic image, first film
$41K
18K claims · 0.2%
$33K
491 claims · 0.2%
$9K
184 claims · 0.1%
$6K
115 claims · 0.0%