Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#2091 of 11K

D5213

HCPCS Procedure Code

HCPCS code D5213 is the #2,091 most-billed Medicaid procedure code, with $9.2M in payments across 20K claims from 2018–2024. The national median cost per claim is $549.94.

Total Paid

$9.2M

0.00% of all spending

Total Claims

20K

Providers

133

Avg Cost/Claim

$457

National Cost Distribution

How much do providers bill per claim for D5213? Based on 127 providers billing this code nationally.

Median

$549.94

Average

$640.29

Std Dev

$299.94

Max

$2,082.36

Percentile Distribution (Cost per Claim)

p10
$278.08
p25
$484.28
Median
$549.94
p75
$893.25
p90
$988.25
p95
$1,039.97
p99
$1,107.72

50% of providers bill between $484.28 and $893.25 per claim for this code.

90% bill between $278.08 and $988.25.

Top 1% bill above $1,107.72.

About This Procedure

HCPCS code D5213 was billed by 133 providers across 20K claims, totaling $9.2M in Medicaid payments from 2018–2024. This code was used for 18K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$549.94

Providers Billing

127

National Spending

$9.2M

Avg/Median Ratio

1.16×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for D5213

#ProviderTotal Paid
1My Community Dental Centers Inc

Petoskey, MI · Dentist, Dental Public Health

$2.4M
21447441720$876K
31528139540$477K
41124164926$358K
51437320520$354K
61699028597$346K
71841308087$335K
81235406927$217K
91245398452$189K
101467755371$183K
111982787537$173K
121366655235$171K
131609956234$147K
141164555124$143K
151407412992$133K
161689779282$124K
171548834872$121K
181528105483$119K
191548779135$100K
201427199181$93K

Showing top 20 of 133 providers billing this code