Extract data from dental claims

A dental claim is the ADA-format request a dental practice sends a plan to be paid for treatment, and what sets it apart from a medical claim is its coding. Where a physician's claim on a CMS-1500 uses CPT codes and a hospital's institutional claim on a UB-04 bills by revenue code, a dental claim uses CDT codes and pins each service to a specific tooth and surface. The practice's billing coordinator, the plan's adjudicator, and the patient checking an explanation of benefits all read the same claim. When Bayside Dental Group (NPI 1477829365) submits a claim for patient Maria Alvarez to Delta Dental of California on 2026-06-20 for services on 2026-06-15, the document itemizes exactly which teeth were treated and how. Service lines are where a dental claim is unusually precise. A CDT code such as D2740 for a porcelain crown is tied to a tooth_number in FDI notation, here tooth 26, the upper-left first molar, while a filling records the tooth_surface treated using the mesial, occlusal, distal, lingual, incisal, and buccal codes. Money has to reconcile across three figures: the billed_amount of 1,435 USD is the sum of the line charges, the allowed_amount of 1,053 USD is what the plan recognizes, and the paid_amount of 578 USD is what it pays after a 50 USD deductible and a 50 percent coinsurance on the major service. Patient responsibility of 475 USD is the allowed amount less the paid amount, so allowed foots to paid plus patient share. Given a dental claim, Talonic returns the patient, provider, and payer blocks, the claim totals, and the adjudication figures as typed fields, keeping the service lines as a table with each CDT code, tooth, and surface, and reconciling the line charges to the claim total. A claim billing 1,435 USD across a crown, a cleaning, and an exam, with 578 USD paid and 475 USD left to the patient, loads into a practice management system as structured data. Every field on a dental claim, from the patient name and date of birth to the diagnosis and the amounts, is protected health information (PHI), so it is handled under the privacy controls that govern any patient record, returned as written, with no CDT coding for billing and no interpretation of the treatment.

What gets extracted from dental claims

How extraction works for dental claims

Dental claims arrive as ADA claim forms, X12 837 submissions rendered to PDF, and clearinghouse printouts, so the CDT codes, the tooth and surface, and the adjudication amounts sit in different layouts by plan. Classification aligns the claim with the dental-claim schema in the Field Registry, which separates the patient, provider, and payer blocks from the service lines and the patient benefits. Each service line is typed with its CDT code, its tooth_number in FDI notation, the tooth_surface treated, the quantity, and the unit price, and the line totals are summed and checked against the billed_amount, so a 1,435 USD claim that does not foot from its lines is flagged. Billed, allowed, and paid amounts are typed as numbers in their ISO 4217 currency, the deductible_applied and coinsurance_percentage are read so the patient_responsibility can be checked as allowed less paid, and the provider NPI and taxonomy_code are kept for the billing provider. Every value returns with a confidence score and a source-region pointer consistent with DIN SPEC 91491, so a billing coordinator can verify a tooth, a code, or an amount against the claim. Because these fields are PHI, they return only to the account that submitted the document, and no coding, adjudication, or pricing is performed.

Sample extraction

An ADA dental claim with adjudicated service lines

{
  "document_number": "DCL-2026-778120",
  "document_date": "2026-06-20",
  "claim_type": "oral",
  "claim_status": "approved",
  "patient.name": "Maria Alvarez",
  "patient.member_id": "DDC-556201883",
  "patient.date_of_birth": "1989-04-12",
  "provider.name": "Bayside Dental Group",
  "provider.npi": "1477829365",
  "provider.taxonomy_code": "1223G0001X",
  "payer.name": "Delta Dental of California",
  "payer.payer_id": "94276",
  "service_date_from": "2026-06-15",
  "service_date_to": "2026-06-15",
  "total_amount": 1435,
  "billed_amount": 1435,
  "allowed_amount": 1053,
  "paid_amount": 578,
  "patient_responsibility": 475,
  "deductible_applied": 50,
  "coinsurance_percentage": 50,
  "adjudication_outcome": "partial",
  "plan_name": "Delta Dental PPO",
  "service_lines": [
    {
      "line_number": "1",
      "cdt_code": "D0120",
      "service_description": "Periodic oral evaluation",
      "quantity": 1,
      "unit_price": 65,
      "line_total": 65,
      "serviced_date": "2026-06-15",
      "allowed_amount": 55,
      "paid_amount": 55,
      "patient_responsibility": 0,
      "status": "approved"
    },
    {
      "line_number": "2",
      "cdt_code": "D1110",
      "service_description": "Prophylaxis, adult",
      "quantity": 1,
      "unit_price": 120,
      "line_total": 120,
      "serviced_date": "2026-06-15",
      "allowed_amount": 98,
      "paid_amount": 98,
      "patient_responsibility": 0,
      "status": "approved"
    },
    {
      "line_number": "3",
      "cdt_code": "D2740",
      "service_description": "Crown, porcelain/ceramic",
      "tooth_number": "26",
      "oral_cavity_designation": "upper left",
      "quantity": 1,
      "unit_price": 1250,
      "line_total": 1250,
      "serviced_date": "2026-06-15",
      "allowed_amount": 900,
      "paid_amount": 425,
      "patient_responsibility": 475,
      "status": "approved"
    }
  ],
  "patient_benefits": [
    {
      "benefit_type": "preventive",
      "coverage_percentage": 100,
      "annual_maximum": 2000,
      "annual_used": 578,
      "annual_remaining": 1422
    },
    {
      "benefit_type": "major",
      "coverage_percentage": 50,
      "annual_maximum": 2000,
      "annual_used": 578,
      "annual_remaining": 1422
    }
  ]
}

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