#56 of 11K

D1120

Prophylaxis, adult

Prophylaxis, adult is the #56 most-billed Medicaid procedure code, with $3.62B in payments across 108.3M claims from 2018–2024. The national median cost per claim is $33.86.

Total Paid

$3.62B

0.33% of all spending

Total Claims

108.3M

Providers

42K

Avg Cost/Claim

$33

National Cost Distribution

How much do providers bill per claim for D1120? Based on 41K providers billing this code nationally.

Median

$33.86

Average

$33.37

Std Dev

$18.78

Max

$661.48

Percentile Distribution (Cost per Claim)

p10

$18.24

p25

$26.65

Median

$33.86

p75

$39.92

p90

$45.28

p95

$50.60

p99

$64.26

50% of providers bill between $26.65 and $39.92 per claim for this code.

90% bill between $18.24 and $45.28.

Top 1% bill above $64.26.

About This Procedure

HCPCS code D1120 (Prophylaxis, adult) was billed by 42K providers across 108.3M claims, totaling $3.62B in Medicaid payments from 2018–2024. This code was used for 104.6M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$33.86

Providers Billing

41K

National Spending

$3.62B

Avg/Median Ratio

0.99×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for D1120

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Candler Road Dental, Pc Decatur, GA · Dentist, Endodontics	$12.6M	$31.10	0.9× median	Below Median
2	Arrow Dental Pllc Lexington, KY · Dentist Orthodontics and Dentofacial Orthopedics	$9.6M	$53.65	1.6× median	Top 10%
3	1669726048	$9.4M	$34.98	1.0× median	Above Median
4	Marn Dds Dental Practice P.c. Los Angeles, CA · Dentist General Practice	$8.4M	$37.09	1.1× median	Above Median
5	1366772402	$8.0M	$43.96	1.3× median	Above 75th
6	1205922705	$7.7M	$38.19	1.1× median	Above Median
7	1821486754	$7.6M	$39.35	1.2× median	Above Median
8	1184877201	$7.1M	$44.36	1.3× median	Above 75th
9	Rock Dental Arkansas Pllc Hot Springs, AR · Dentist, Orthodontics and Dentofacial Orthopedics	$7.0M	$33.37	1.0× median	Below Median
10	1316937964	$6.9M	$31.85	0.9× median	Below Median
11	Dental Health Group Pa Bloomfield Hills, MI · Dentist	$6.9M	$37.82	1.1× median	Above Median
12	1649389560	$6.8M	$37.26	1.1× median	Above Median
13	1841638624	$6.1M	$40.42	1.2× median	Above 75th
14	D4c Of Texas Pllc Austin, TX · Clinic/Center, Dental	$6.0M	$34.06	1.0× median	Above Median
15	1386982288	$5.8M	$33.00	1.0× median	Below Median
16	1609273101	$5.7M	$39.11	1.2× median	Above Median
17	1255638284	$5.6M	$38.76	1.1× median	Above Median
18	1992892616	$5.5M	$39.44	1.2× median	Above Median
19	Tremont Road Dental, Pc Newport News, VA · Dentist, Endodontics	$5.4M	$26.93	0.8× median	Below Median
20	Smile New York Outreach Llc Long Island City, NY · Clinic/Center Dental	$5.4M	$37.08	1.1× median	Above Median

Showing top 20 of 42K providers billing this code

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