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Provider 1013158484

NPI: 1013158484Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$15.2M

$15,195,401

Total Claims

392K

Beneficiaries

318K

1.2 claims/patient

Avg Cost/Claim

$39

Monthly Spending Trend

Yearly Spending

2018
$2.7M
-14%
2019
$2.3M
-42%
2020
$1.4M
+36%
2021
$1.8M
+2%
2022
$1.9M
+47%
2023
$2.8M
-15%
2024
$2.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (D1120 (Prophylaxis, adult)) accounts for 14% of total spending.

D1120Top 25%

Prophylaxis, adult

$2.2M

54K claims · 14.3%

Your Cost: $40.63/claim|Median: $33.86
1.2× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$1.6M

18K claims · 10.5%

Your Cost: $88.79/claim|Median: $71.00
1.3× median
D1206Top 25%

Topical application of fluoride varnish

$1.3M

50K claims · 8.3%

Your Cost: $25.06/claim|Median: $18.12
1.4× median
D0120Top 25%

Periodic oral evaluation, established patient

$1.2M

40K claims · 7.8%

Your Cost: $29.82/claim|Median: $24.34
1.2× median
D0150Top 25%

Comprehensive oral evaluation, new or established patient

$1.1M

22K claims · 7.1%

Your Cost: $49.11/claim|Median: $32.07
1.5× median
D2391Normal range

Resin-based composite, one surface, posterior

$1.0M

14K claims · 6.9%

Your Cost: $73.73/claim|Median: $54.60
1.4× median
D8670Normal range

Periodic orthodontic treatment visit

$973K

16K claims · 6.4%

Your Cost: $61.64/claim|Median: $185.01
0.3× median
D0330Top 25%

Panoramic radiographic image

$950K

17K claims · 6.3%

Your Cost: $54.78/claim|Median: $37.36
1.5× median
D1351Top 25%

Sealant, per tooth

$876K

25K claims · 5.8%

Your Cost: $35.64/claim|Median: $26.10
1.4× median
D0274Top 25%

Bitewings, four radiographic images

$679K

21K claims · 4.5%

Your Cost: $33.03/claim|Median: $22.54
1.5× median
D0272Top 10%

Bitewings, two radiographic images

$488K

19K claims · 3.2%

Your Cost: $25.41/claim|Median: $15.81
1.6× median
D7240Normal range

Extraction, impacted tooth, complete bony

$456K

2,135 claims · 3.0%

Your Cost: $213.64/claim|Median: $231.00
0.9× median
D0220Top 25%

Intraoral periapical radiographic image, first film

$388K

29K claims · 2.6%

Your Cost: $13.54/claim|Median: $10.51
1.3× median
D7140Top 25%

Extraction, erupted tooth or exposed root

$283K

3,195 claims · 1.9%

Your Cost: $88.49/claim|Median: $57.39
1.5× median
D0230Top 25%

Intraoral, periapical radiographic image, first film

$282K

24K claims · 1.9%

Your Cost: $11.92/claim|Median: $7.33
1.6× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$279K

2,603 claims · 1.8%

Your Cost: $107.26/claim|Median: $84.26
1.3× median
D0140Normal range

Limited oral evaluation, problem focused

$253K

8,250 claims · 1.7%

Your Cost: $30.65/claim|Median: $27.07
1.1× median
D1110Normal range

Prophylaxis, adult cleaning

$177K

5,673 claims · 1.2%

Your Cost: $31.11/claim|Median: $43.38
0.7× median
D7210Normal range

Extraction, erupted tooth, surgical approach

$149K

1,422 claims · 1.0%

Your Cost: $104.98/claim|Median: $109.42
1.0× median
D9230Top 25%

Inhalation of nitrous oxide/analgesia, anxiolysis

$108K

2,888 claims · 0.7%

Your Cost: $37.35/claim|Median: $26.24
1.4× median
D7111Top 10%

$103K

1,353 claims · 0.7%

Your Cost: $76.04/claim|Median: $49.49
1.5× median
D7230Normal range

Extraction, impacted tooth, partial bony

$103K

482 claims · 0.7%

Your Cost: $212.72/claim|Median: $187.09
1.1× median
D2991Normal range

$96K

1,683 claims · 0.6%

Your Cost: $57.22/claim|Median: $56.50
1.0× median
D1208Top 25%

Topical application of fluoride, excluding varnish

$86K

3,850 claims · 0.6%

Your Cost: $22.30/claim|Median: $14.36
1.6× median
D2335Top 25%

$40K

277 claims · 0.3%

Your Cost: $145.62/claim|Median: $105.06
1.4× median
D8080Normal range

Comprehensive orthodontic treatment, adolescent dentition

$21K

48 claims · 0.1%

Your Cost: $441.16/claim|Median: $968.00
0.5× median
D2332Top 25%

$13K

111 claims · 0.1%

Your Cost: $112.74/claim|Median: $87.21
1.3× median
D2930Normal range

Prefabricated stainless steel crown, primary tooth

$11K

143 claims · 0.1%

Your Cost: $78.32/claim|Median: $120.85
0.6× median
D2394Top 25%

$10K

64 claims · 0.1%

Your Cost: $156.35/claim|Median: $102.14
1.5× median
D0470Top 5%

$9K

100 claims · 0.1%

Your Cost: $87.36/claim|Median: $34.50
2.5× median
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