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Provider 1023122736

NPI: 1023122736Share
Active Billing Period:2018-01→2024-12(83 months)

Total Paid

$10.4M

$10,420,155

Total Claims

131K

Beneficiaries

80K

1.6 claims/patient

Avg Cost/Claim

$79

Monthly Spending Trend

Yearly Spending

2018
$1.3M
+2%
2019
$1.3M
-22%
2020
$994K
+42%
2021
$1.4M
+10%
2022
$1.6M
+35%
2023
$2.1M
-14%
2024
$1.8M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (D2930 (Prefabricated stainless steel crown, primary tooth)) accounts for 62% of total spending.

D2930Top 25%

Prefabricated stainless steel crown, primary tooth

$6.5M

44K claims · 62.1%

Your Cost: $147.72/claim|Median: $120.85
1.2× median
D9420Normal range

$903K

7,465 claims · 8.7%

Your Cost: $120.95/claim|Median: $81.82
1.5× median
D0120Normal range

Periodic oral evaluation, established patient

$370K

14K claims · 3.6%

Your Cost: $25.93/claim|Median: $24.34
1.1× median
D7140Normal range

Extraction, erupted tooth or exposed root

$350K

5,320 claims · 3.4%

Your Cost: $65.74/claim|Median: $57.39
1.1× median
D9223Top 10%

Deep sedation/general anesthesia, each additional 15 min

$304K

703 claims · 2.9%

Your Cost: $433.13/claim|Median: $107.14
4.0× median
D1120Normal range

Prophylaxis, adult

$285K

10K claims · 2.7%

Your Cost: $27.58/claim|Median: $33.86
0.8× median
D2392Top 25%

Resin-based composite, two surfaces, posterior

$279K

2,605 claims · 2.7%

Your Cost: $107.21/claim|Median: $71.00
1.5× median
D1206Normal range

Topical application of fluoride varnish

$229K

14K claims · 2.2%

Your Cost: $16.15/claim|Median: $18.12
0.9× median
D1110Normal range

Prophylaxis, adult cleaning

$195K

5,087 claims · 1.9%

Your Cost: $38.40/claim|Median: $43.38
0.9× median
D2932Top 25%

$179K

1,034 claims · 1.7%

Your Cost: $173.06/claim|Median: $113.10
1.5× median
D2933Top 25%

$144K

797 claims · 1.4%

Your Cost: $180.92/claim|Median: $145.67
1.2× median
D0240Normal range

$124K

7,487 claims · 1.2%

Your Cost: $16.56/claim|Median: $15.24
1.1× median
D0272Normal range

Bitewings, two radiographic images

$104K

6,201 claims · 1.0%

Your Cost: $16.80/claim|Median: $15.81
1.1× median
D9230Top 10%

Inhalation of nitrous oxide/analgesia, anxiolysis

$71K

1,571 claims · 0.7%

Your Cost: $45.01/claim|Median: $26.24
1.7× median
D0274Top 25%

Bitewings, four radiographic images

$65K

2,106 claims · 0.6%

Your Cost: $30.99/claim|Median: $22.54
1.4× median
D3220Normal range

Therapeutic pulpotomy

$65K

792 claims · 0.6%

Your Cost: $82.06/claim|Median: $81.27
1.0× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$60K

1,341 claims · 0.6%

Your Cost: $44.47/claim|Median: $32.07
1.4× median
D1351Normal range

Sealant, per tooth

$54K

1,930 claims · 0.5%

Your Cost: $28.12/claim|Median: $26.10
1.1× median
D9222Normal range

Deep sedation/general anesthesia, first 15 minutes

$43K

704 claims · 0.4%

Your Cost: $61.40/claim|Median: $90.28
0.7× median
D0330Normal range

Panoramic radiographic image

$22K

464 claims · 0.2%

Your Cost: $46.40/claim|Median: $37.36
1.2× median
D2934Top 25%

$21K

106 claims · 0.2%

Your Cost: $195.68/claim|Median: $143.67
1.4× median
D0220Top 10%

Intraoral periapical radiographic image, first film

$12K

809 claims · 0.1%

Your Cost: $15.21/claim|Median: $10.51
1.4× median
D0160Top 25%

$9K

140 claims · 0.1%

Your Cost: $67.49/claim|Median: $34.71
1.9× median
D2150Top 10%

Amalgam, two surfaces, primary or permanent

$9K

99 claims · 0.1%

Your Cost: $92.44/claim|Median: $66.00
1.4× median
D9248Normal range

$9K

662 claims · 0.1%

Your Cost: $13.66/claim|Median: $92.49
0.1× median
D1208Normal range

Topical application of fluoride, excluding varnish

$8K

514 claims · 0.1%

Your Cost: $16.18/claim|Median: $14.36
1.1× median
D3230Top 25%

$8K

65 claims · 0.1%

Your Cost: $125.59/claim|Median: $98.27
1.3× median
D2391Top 25%

Resin-based composite, one surface, posterior

$8K

97 claims · 0.1%

Your Cost: $81.66/claim|Median: $54.60
1.5× median
D0140Normal range

Limited oral evaluation, problem focused

$5K

153 claims · 0.1%

Your Cost: $35.31/claim|Median: $27.07
1.3× median
D2330Normal range

Resin-based composite filling, one surface, anterior

$4K

59 claims · 0.0%

Your Cost: $64.09/claim|Median: $66.63
1.0× median
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