Dental Client Report CITY OF OKLAHOMA CITY (2024 and 2023) CUR 01-01-24_12-31-24 PRI 01-01-23_12-31-23.pdf

Dental Insight Report

Prepared for CITY OF OKLAHOMA CITY (2024 and 2023) Report Created on 01/14/2025 Current Period: 01-2024 TO 12-2024

Prior Period: 01-2023 TO 12-2023

Current Prior 11,435 11,049

Membs w cleaning or exam 7,267 6,927 EEs w cleaning or exam 3,252 3,118 DEPs w cleaning or exam 4,015 3,809

Utilization 84.5% 83.3% Discount 41.2% 40.5%

69.6% 68.4%

69.4% 68.9%

*Do not save modifications copied elsewhere

Members with Claims

Savings

Average Members

Network Performance

$40.83

$99.63

$210.61

$371.52

$104.93

$243.46

$96.07

$130.33

$86.46

Diagnostic & Preventive

Basic Restorative Major Restorative Endodontics Periodontics Prosthodontics Oral Surgery Orthodontics Miscellaneous

Average Cost per Procedure

Proprietary and ConfidentialPage 1 of 11 CITY OF OKLAHOMA CITY (2024 and 2023)

Current Period:

Prior Period:

Paid Claims Procedures Subscribers Members

Current 3,561,434$ 57,082 5,457 11,435

Prior 3,314,371$ 53,499 5,268 11,049

Variance 247,063$ 3,583 189 386

% 7.5% 6.7% 3.6% 3.5%

Dental Experience

01-2024 TO 12-2024

01-2023 TO 12-2023

$500,000

$1,000,000

$1,500,000

$2,000,000

$2,500,000

$3,000,000

$3,500,000

$4,000,000

Paid Claims

Current Prior

2,000

4,000

6,000

8,000

10,000

12,000

14,000

Subscribers Members

Current Prior

10,000

20,000

30,000

40,000

50,000

60,000

Procedures

Current Prior

Proprietary and ConfidentialPage 2 of 11 CITY OF OKLAHOMA CITY (2024 and 2023)

Month Paid Claims Procedures Subscribers Members Paid Claims Procedures Subscribers Members

January 289,625$ 4,475 5,391 11,320 287,537$ 4,226 5,198 11,026

February 321,215$ 4,603 5,393 11,346 268,097$ 4,186 5,174 10,967

March 319,401$ 4,999 5,424 11,399 324,045$ 5,153 5,213 11,015

April 323,283$ 4,941 5,436 11,407 278,144$ 4,173 5,217 10,987

May 343,349$ 5,515 5,451 11,445 298,128$ 4,753 5,239 11,015

June 277,074$ 4,522 5,459 11,445 306,375$ 4,875 5,244 10,987

July 272,497$ 4,616 5,450 11,436 252,555$ 4,338 5,266 11,016

August 308,398$ 4,970 5,447 11,416 296,064$ 4,946 5,309 11,100

September 256,646$ 4,262 5,479 11,465 245,035$ 3,960 5,332 11,126

October 295,135$ 4,731 5,505 11,502 257,687$ 4,538 5,345 11,140

November 270,902$ 4,704 5,519 11,515 252,216$ 4,328 5,347 11,127

December 283,908$ 4,744 5,526 11,524 248,488$ 4,023 5,326 11,084

Total 3,561,434$ 57,082 5,457 11,435 3,314,371$ 53,499 5,268 11,049

Monthly Dental Experience

Current Period Prior Period

$50,000

$100,000

$150,000

$200,000

$250,000

$300,000

$350,000

$400,000

Paid Claims Current

Prior

1,000

2,000

3,000

4,000

5,000

6,000

Procedures Current

Prior

Proprietary and ConfidentialPage 3 of 11 CITY OF OKLAHOMA CITY (2024 and 2023)

Dental Claim Dollar Utilization - Paid: 01-2024 TO 12-2024

11,435

Category Paid Claims

Percent of

Claims Procedures

Percent of

Procedures per Member per

Procedure PMPM Group Benchmark

Diagnostic & Preventive 1,824,634$ 51.2% 44,689 78.3% 159.57$ 40.83$ 13.30$ 3908.0892 3,152

Basic Restorative 419,923$ 11.8% 4,215 7.4% 36.72$ 99.63$ 3.06$ 369 383

Major Restorative 464,387$ 13.0% 2,205 3.9% 40.61$ 210.61$ 3.38$ 193 134

Endodontics 144,150$ 4.0% 388 0.7% 12.61$ 371.52$ 1.05$ 34 32

Periodontics 140,297$ 3.9% 1,337 2.3% 12.27$ 104.93$ 1.02$ 117 164

Prosthodontics 205,721$ 5.8% 845 1.5% 17.99$ 243.46$ 1.50$ 74 35

Oral Surgery 174,184$ 4.9% 1,813 3.2% 15.23$ 96.07$ 1.27$ 159 124

Orthodontics 150,527$ 4.2% 1,155 2.0% 13.16$ 130.33$ 1.10$ 101 116

Miscellaneous 37,609$ 1.1% 435 0.8% 3.29$ 86.46$ 0.27$ 38 38

Total 3,561,434$ 100.0% 57,082 100.0% 311.45$ 62.39$ 25.95$ 4,992 4,180

Average Members Procedures per 1,000 members per yearClaim Dollars

51.2%

11.8%

13.0%

4.0%

3.9%

5.8%

4.9% 4.2%

1.1%

Percent of Claims

78.3%

7.4%

3.9% 0.7%

2.3% 1.5%

3.2% 2.0% 0.8%

Percent of Procedures

13.30

3.06

3.38

1.05

1.02

1.50

1.27

1.10

0.27

Diagnostic & Preventive

Basic Restorative

Major Restorative

Endodontics

Periodontics

Prosthodontics

Oral Surgery

Orthodontics

Miscellaneous

Claim Dollars PMPM

Proprietary and ConfidentialPage 4 of 11 CITY OF OKLAHOMA CITY (2024 and 2023)

Dental Claim Dollar Utilization - Paid

Category Current Prior % Current Prior % Current Prior % Current Prior %

Diagnostic & Preventive 1,824,634$ 1,647,255$ 10.8% 44,689 41,717 7.1% 13.30$ 12.42$ 7.0% 40.83$ 39.49$ 3.4%

Basic Restorative 419,923$ 380,550$ 10.3% 4,215 3,942 6.9% 3.06$ 2.87$ 6.6% 99.63$ 96.54$ 3.2%

Major Restorative 464,387$ 430,657$ 7.8% 2,205 2,130 3.5% 3.38$ 3.25$ 4.2% 210.61$ 202.19$ 4.2%

Endodontics 144,150$ 164,359$ -12.3% 388 469 -17.3% 1.05$ 1.24$ -15.3% 371.52$ 350.45$ 6.0%

Periodontics 140,297$ 130,551$ 7.5% 1,337 1,242 7.6% 1.02$ 0.98$ 3.8% 104.93$ 105.11$ -0.2%

Prosthodontics 205,721$ 222,477$ -7.5% 845 852 -0.8% 1.50$ 1.68$ -10.7% 243.46$ 261.12$ -6.8%

Oral Surgery 174,184$ 163,998$ 6.2% 1,813 1,578 14.9% 1.27$ 1.24$ 2.6% 96.07$ 103.93$ -7.6%

Orthodontics 150,527$ 136,635$ 10.2% 1,155 1,082 6.7% 1.10$ 1.03$ 6.4% 130.33$ 126.28$ 3.2% Miscellaneous 37,609$ 37,888$ -0.7% 435 487 -10.7% 0.27$ 0.29$ -4.1% 86.46$ 77.80$ 11.1%

Total 3,561,434$ 3,314,371$ 7.5% 57,082 53,499 6.7% 25.95$ 25.00$ 3.8% 62.39$ 61.95$ 0.7%

Paid Claims Procedures Claims PMPM Average Cost per Procedure

-20.0%

-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

20.0%

Diagnostic & Preventive

Basic Restorative Major Restorative

Endodontics Periodontics Prosthodontics Oral Surgery Orthodontics Miscellaneous Total

Changes in Utilization Average Cost per Procedure

Claims PMPM

Paid Amount

Procedures

Proprietary and ConfidentialPage 5 of 11 CITY OF OKLAHOMA CITY (2024 and 2023)

Dental Claim Savings

Current % of Billed Prior % of Billed

Billed 11,621,982$ 10,650,286$

PPO Savings U&C Fee/MAC 3,384,210$ 29.1% 3,048,795$ 28.6%

Other Savings * 2,639,859$ 22.7% 2,445,018$ 23.0%

Coordination of Benefits 86,134$ 0.7% 72,719$ 0.7%

Eligibility 132,584$ 1.1% 114,987$ 1.1%

Coinsurance 1,254,106$ 10.8% 1,195,436$ 11.2%

Deductible 151,926$ 1.3% 147,888$ 1.4%

Not Covered 411,728$ 3.5% 311,072$ 2.9%

Plan Paid 3,561,434$ 30.6% 3,314,371$ 31.1%

Savings 8,060,548$ 7,335,916$

Savings % 69.4% 68.9%

* Other Savings include Utilization Management, Professional Review, Alternate Benefit, Plan Max

Approved Claims

Billed 9,171,486$ 8,419,159$

Allowed 5,800,632$ 5,389,043$

Procedure Count 57,082 53,499

Current Prior

Plan Paid

Not Covered

Deductible

Coinsurance

Eligibility

Coordination of Benefits

Other Savings *

PPO Savings U&C Fee/MAC

Proprietary and ConfidentialPage 6 of 11 CITY OF OKLAHOMA CITY (2024 and 2023)

Dental Claim Savings - In Network

Billed 9,797,148$ 8,745,942$

PPO Savings 3,204,734$ 32.7% 2,859,741$ 32.7%

Other Savings * 2,163,391$ 22.1% 1,822,079$ 20.8%

Coordination of Benefits 67,470$ 0.7% 56,684$ 0.6%

Eligibility 81,824$ 0.8% 71,432$ 0.8%

Coinsurance 907,968$ 9.3% 867,711$ 9.9%

Deductible 131,558$ 1.3% 127,610$ 1.5%

Not Covered 348,608$ 3.6% 244,868$ 2.8%

Plan Paid 2,891,597$ 29.5% 2,695,815$ 30.8%

Savings 6,905,552$ 6,050,126$

Savings % 70.5% 69.2%

* Other Savings include Utilization Management, Professional Review, Alternate Benefit, Plan Max

Approved Claims

Billed 7,753,377$ 7,013,898$

Allowed 4,559,758$ 4,171,067$

Procedure Count 49,747 46,306

Network Discount 41.2% 40.5%

Current Prior

Plan Paid

Not Covered

Deductible

Coinsurance

Eligibility

Coordination of Benefits

Other Savings *

PPO Savings

Proprietary and ConfidentialPage 7 of 11 CITY OF OKLAHOMA CITY (2024 and 2023)

Dental Claim Savings - Out of Network

Billed 1,824,834$ 1,904,345$

U&C Fee/MAC 179,477$ 9.8% 189,054$ 9.9%

Other Savings * 476,468$ 26.1% 622,939$ 32.7%

Coordination of Benefits 18,664$ 1.0% 16,035$ 0.8%

Eligibility 50,760$ 2.8% 43,555$ 2.3%

Coinsurance 346,138$ 19.0% 327,725$ 17.2%

Deductible 20,369$ 1.1% 20,278$ 1.1%

Not Covered 63,120$ 3.5% 66,204$ 3.5%

Plan Paid 669,837$ 36.7% 618,555$ 32.5%

Savings 1,154,997$ 1,285,790$

Savings % 63.3% 67.5%

* Other Savings include Utilization Management, Professional Review, Alternate Benefit, Plan Max

Approved Claims

Billed 1,418,110$ 1,405,261$

Allowed 1,240,874$ 1,217,976$

Procedure Count 7,335 7,193

Current Prior

Plan Paid

Not Covered

Deductible

Coinsurance

Eligibility

Coordination of Benefits

Other Savings *

U&C Fee/MAC

Proprietary and ConfidentialPage 8 of 11 CITY OF OKLAHOMA CITY (2024 and 2023)

Top 25 In Network Dental Providers - Paid: 01-2024 TO 12-2024

Provider Address Tax ID Paid # of

Procedures

Members

Seen

% of Total

Paid

1 MATTHEW COLE DDS 1401 S RANCHWOOD BLVD STE 110 YUKON OK 73099 270995353 45,206$ 628 82 1.3%

2 RYAN L BRACKETT DDS 1300 CROP CIRCLE YUKON OK 73099 842097996 35,916$ 778 121 1.0%

3 MARK D SHIRLEY DDS 2441 SW 134TH ST OKLAHOMA CITY OK 73170 161697252 33,153$ 379 57 0.9%

4 ASHLEY N LANMAN DDS 6532 N MAY AVE OKLAHOMA CITY OK 73116 061755063 31,088$ 634 94 0.9%

5 KIMBERLY MERRITT DDS 1117 NW 32ND ST NEWCASTLE OK 73065 141981193 30,775$ 307 70 0.9%

6 CHRISTOPHER M HAFFNER DDS 8383 S PENNSYLVANIA AVE OKLAHOMA CITY OK 73159 831956023 26,542$ 429 56 0.7%

7 MELANIE D EMERSON DDS 9708 E RENO AVE OKLAHOMA CITY OK 73130 731616532 26,072$ 441 52 0.7%

8 JACOB W MENDENHALL DDS 10900 HEFNER POINT DR STE 204 OKLAHOMA CITY OK 73120 464189630 21,294$ 169 46 0.6%

9 CHRIS A RECKNAGEL DDS 801 N MUSTANG RD STE A YUKON OK 73099 731613618 20,777$ 372 66 0.6%

10 KHALID AL ZUBI DDS 7130 W HEFNER RD OKLAHOMA CITY OK 73162 208697466 20,527$ 358 48 0.6%

11 STEVEN H TRUONG DDS 16 NE 2ND ST STE B OKLAHOMA CITY OK 73104 462590326 20,391$ 256 35 0.6%

12 LORI C HOLDEN DDS 1117 NW 32ND ST NEWCASTLE OK 73065 141981193 19,838$ 249 59 0.6%

13 GEORGE F NAIFEH DDS 11900 N PENNSYLVANIA AVE STE A5 OKLAHOMA CITY OK 73120 731161091 19,676$ 241 38 0.6%

14 MHD KOUZBARI DDS 5691 TINKER DIAGONAL MIDWEST CITY OK 73110 202225597 19,472$ 386 56 0.5%

15 ANH BUI DDS 7120 S PENNSYLVANIA AVE OKLAHOMA CITY OK 73159 833169405 19,454$ 242 34 0.5%

16 CLINT E PITT DDS 1701 S MORGAN RD OKLAHOMA CITY OK 73128 462046981 17,962$ 201 33 0.5%

17 JOSEPH SEBOURN DDS 3104 NW 23RD ST OKLAHOMA CITY OK 73107 731048272 17,709$ 326 53 0.5%

18 STEVEN M KENDRICK DDS 570 S POST RD MIDWEST CITY OK 73130 460512305 17,631$ 257 35 0.5%

19 TUNG NGUYEN DDS 820 S MUSTANG RD YUKON OK 73099 462407557 17,447$ 302 36 0.5%

20 OMAR RASHEED DDS 3104 NW 23RD ST OKLAHOMA CITY OK 73107 731048272 17,397$ 316 52 0.5%

21 JEFFREY SCAMMAHORN DDS 11521 S WESTERN AVE STE C OKLAHOMA CITY OK 73170 830797792 16,752$ 350 47 0.5%

22 STEPHEN BUCHANAN DDS 3001 NW 63RD ST OKLAHOMA CITY OK 73116 273382885 16,493$ 294 28 0.5%

23 GREGORY CLIFFORD DDS 13100 COLONYPOINTE BLVD STE 106 PIEDMONT OK 73078 475352444 16,100$ 297 38 0.5%

24 MONTE J CAREL DDS 317 S SARA RD MUSTANG OK 73064 260533440 16,014$ 412 48 0.4%

25 JUDSON MAY DDS 14310 DALE STEARNS DR CHOCTAW OK 73020 454276429 15,686$ 354 43 0.4%

Percentage of Total 15.7%

Proprietary and ConfidentialPage 9 of 11 CITY OF OKLAHOMA CITY (2024 and 2023)

Top 25 Out of Network Dental Providers - Paid: 01-2024 TO 12-2024

Provider Address Tax ID Paid # of

Procedures

Members

Seen

% of Total

Paid

1 DANIEL J WILGUESS DDS 233 E 10TH STREET PLZ EDMOND OK 73034 432083958 20,980$ 199 40 0.6%

2 SANDY A GRACE DDS 5619 N PENNSYLVANIA AVE OKLAHOMA CITY OK 73112 800011421 16,413$ 105 16 0.5%

3 MITCHELL W KRAMER DDS 233 E 10TH STREET PLZ EDMOND OK 73034 432083958 14,426$ 143 29 0.4%

4 ROBI L CRAIG DDS 12100 S WESTERN AVE OKLAHOMA CITY OK 73170 463130306 13,499$ 85 21 0.4%

5 RYAN A STREIGHT DDS 1476 N MUSTANG RD MUSTANG OK 73064 463130306 13,217$ 118 17 0.4%

6 MICHAEL L CHANDLER DDS 12 NW 150TH ST EDMOND OK 73013 753152756 12,621$ 155 23 0.4%

7 MARK T PHAN DDS 13900 S WESTERN SUITE 300 OKLAHOMA CITY OK 73170 461650071 10,158$ 81 17 0.3%

8 KEVIN MURRAY DDS 13900 S WESTERN SUITE 300 OKLAHOMA CITY OK 73170 461650071 9,277$ 93 24 0.3%

9 JOHN R DANNER DDS 4514 MEMORIAL CIR STE A OKLAHOMA CITY OK 73142 731491460 8,974$ 114 16 0.3%

10 OKLAHOMA MEDICAID PO BOX 678831 DALLAS TX 75267 731476619 8,769$ 272 48 0.2%

11 MELISSA L FARROW DDS 8301 S WALKER AVE STE 103 OKLAHOMA CITY OK 73139 262865536 8,397$ 37 10 0.2%

12 TRACI LEON DDS 2812 W HEFNER RD OKLAHOMA CITY OK 73120 824878894 8,289$ 72 9 0.2%

13 BOBBY J CARMEN DDS 1141 SONOMA PARK DR NORMAN OK 73071 204742600 7,975$ 110 17 0.2%

14 SHANNON M LEWIS DDS 2900 N KELLY AVE EDMOND OK 73003 205020361 7,898$ 53 9 0.2%

15 SHYLER D VINCENT DDS 6305 WATERFORD BLVD STE 445 OKLAHOMA CITY OK 73118 451844211 7,744$ 89 15 0.2%

16 HEATH A WHITFIELD DDS 101 S SAINTS BLVD STE 212 EDMOND OK 73034 881440502 7,166$ 115 15 0.2%

17 MICHAEL D HAMPTON DDS 1908 S POST RD BLDG 2 OKLAHOMA CITY OK 73130 731241314 7,139$ 93 10 0.2%

18 KRISTIN R CAMPBELL DDS 420 24TH AVE SW NORMAN OK 73069 822698076 7,046$ 70 14 0.2%

19 CHRISTOPHER N CORBIN DDS 4228 N MERIDIAN AVE OKLAHOMA CITY OK 73112 731488019 6,963$ 53 15 0.2%

20 JIMMIE O TAYLOR DDS 13429 N MACARTHUR BLVD STE 5 OKLAHOMA CITY OK 73142 921111525 6,916$ 112 27 0.2%

21 TAMARA S BERG DDS 910 S YUKON PKWY YUKON OK 73099 731541129 6,692$ 79 16 0.2%

22 CLARK TORBERT DDS 3645 N COUNCIL RD BETHANY OK 73008 815057877 6,334$ 60 13 0.2%

23 MICHAEL K KIRK DDS 1057 NW GRAND BLVD OKLAHOMA CITY OK 73118 262873521 6,182$ 96 11 0.2%

24 KRISTI L COBB DDS 1108 N MUSTANG RD MUSTANG OK 73064 731617602 6,128$ 61 18 0.2%

25 ELIZABETH BOHANON DDS 11016 QUAIL CREEK RD OKLAHOMA CITY OK 73120 205349892 6,077$ 84 10 0.2%

Percentage of Total 6.6%

Proprietary and ConfidentialPage 10 of 11 CITY OF OKLAHOMA CITY (2024 and 2023)

Top 25 Procedures - Paid: 01-2024 TO 12-2024

Code Description Paid Count

1 1110 PROPHYLAXIS - ADULT 555,660$ 8,531

2 2740 CROWN - PORCELAIN/CERAMIC 346,402$ 955

3 0120 PERIODIC ORAL EVALUATION - ESTABLISHED PATIENT 330,584$ 9,380

4 0274 BITEWINGS - FOUR RADIOGRAPHIC IMAGES 213,069$ 4,877

5 2392 RESIN-BASED COMPOSITE - TWO SURFACES, POSTERIOR 151,486$ 1,469

6 0330 PANORAMIC RADIOGRAPHIC IMAGE 111,145$ 1,416

7 0220 INTRAORAL - PERIAPICAL FIRST RADIOGRAPHIC IMAGE 107,945$ 5,703

8 0140 LIMITED ORAL EVALUATION - PROBLEM FOCUSED 93,759$ 1,762

9 1120 PROPHYLAXIS - CHILD 87,813$ 1,847

10 0230 INTRAORAL - PERIAPICAL EACH ADDITIONAL RADIOGRAPHIC IMAGE 86,987$ 5,614

11 7210 EXTRACTION, ERUPTED TOOTH REQUIRING REMOVAL OF BONE AND/OR SECTIONING OF TOOTH, AND INCLUDING ELEVATION OF MUCOPERIOSTEAL FLAP IF INDICATED 82,826$ 863

12 3330 ENDODONTIC THERAPY, MOLAR TOOTH (EXCLUDING FINAL RESTORATIONS) 77,857$ 151

13 6010 SURGICAL PLACEMENT OF IMPLANT BODY: ENDOSTEAL IMPLANT 77,288$ 167

14 0150 COMPREHENSIVE ORAL EVALUATION - NEW OR ESTABLISHED PATIENT 75,609$ 1,353

15 2391 RESIN-BASED COMPOSITE - ONE SURFACE, POSTERIOR 75,493$ 943

16 4910 PERIODONTAL MAINTENANCE 73,709$ 700

17 8670 PERIODIC ORTHODONTIC TREATMENT VISIT 68,919$ 966

18 2393 RESIN-BASED COMPOSITE - THREE SURFACES, POSTERIOR 67,815$ 547

19 2950 CORE BUILDUP, INCLUDING ANY PINS WHEN REQUIRED 50,791$ 685

20 1206 TOPICAL APPLICATION OF FLUORIDE VARNISH 49,906$ 1,522

21 4341 PERIODONTAL SCALING AND ROOT PLANING - FOUR OR MORE TEETH PER QUADRANT 42,162$ 402

22 8080 COMPREHENSIVE ORTHODONTIC TREATMENT OF THE ADOLESCENT DENTITION 40,764$ 74

23 7140 EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT (ELEVATION AND/OR FORCEPS REMOVAL) 33,316$ 549

24 3320 ENDODONTIC THERAPY, PREMOLAR TOOTH (EXCLUDING FINAL RESTORATIONS) 33,249$ 85

25 0210 INTRAORAL - COMPREHENSIVE SERIES OF RADIOGRAPHIC IMAGES 30,424$ 319

Percentage of Total 83.3% 89.1%

Proprietary and ConfidentialPage 11 of 11 CITY OF OKLAHOMA CITY (2024 and 2023)