Provider 1982089256
Total Paid
$11.6M
$11,596,173
Total Claims
405K
Beneficiaries
350K
1.2 claims/patient
Avg Cost/Claim
$29
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 22 distinct procedure codes. The top code (D2391 (Resin-based composite, one surface, posterior)) accounts for 18% of total spending.
$2.1M
27K claims
$78.27
$54.60
Resin-based composite, one surface, posterior
$2.1M
27K claims · 18.0%
$1.8M
13K claims
$141.03
$57.30
Oral evaluation for patient under 3 years, counseling
$1.8M
13K claims · 15.7%
Prophylaxis, adult
$1.4M
38K claims · 11.9%
$1.4M
47K claims
$28.56
$24.34
Periodic oral evaluation, established patient
$1.4M
47K claims · 11.6%
$756K
52K claims
$14.51
$14.36
Topical application of fluoride, excluding varnish
$756K
52K claims · 6.5%
Prophylaxis, adult cleaning
$741K
14K claims · 6.4%
$653K
6,418 claims
$101.74
$71.00
Resin-based composite, two surfaces, posterior
$653K
6,418 claims · 5.6%
$635K
59K claims
$10.74
$7.33
Intraoral, periapical radiographic image, first film
$635K
59K claims · 5.5%
Bitewings, four radiographic images
$534K
16K claims · 4.6%
$524K
20K claims
$26.76
$26.24
Inhalation of nitrous oxide/analgesia, anxiolysis
$524K
20K claims · 4.5%
Bitewings, two radiographic images
$340K
15K claims · 2.9%
$276K
23K claims
$11.74
$10.51
Intraoral periapical radiographic image, first film
$276K
23K claims · 2.4%
$182K
1,240 claims
$147.04
$120.85
Prefabricated stainless steel crown, primary tooth
$182K
1,240 claims · 1.6%
$167K
2,393 claims
$69.68
$46.33
Intraoral, complete series of radiographic images
$167K
2,393 claims · 1.4%
$110K
3,206 claims
$34.32
$32.07
Comprehensive oral evaluation, new or established patient
$110K
3,206 claims · 0.9%
$23K
1,274 claims
$18.21
$27.07
Limited oral evaluation, problem focused
$23K
1,274 claims · 0.2%
$17K
345 claims
$50.38
$57.39
Extraction, erupted tooth or exposed root
$17K
345 claims · 0.1%
$4K
52 claims
$74.26
$66.63
Resin-based composite filling, one surface, anterior
$4K
52 claims · 0.0%
Panoramic radiographic image
$3K
567 claims · 0.0%
$3K
233 claims · 0.0%
$0
28K claims · 0.0%
$0
38K claims · 0.0%