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Provider 1023167194

NPI: 1023167194Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$7.9M

$7,941,211

Total Claims

217K

Beneficiaries

181K

1.2 claims/patient

Avg Cost/Claim

$37

Monthly Spending Trend

Yearly Spending

2018
$665K
+45%
2019
$962K
-8%
2020
$885K
+73%
2021
$1.5M
-18%
2022
$1.3M
+45%
2023
$1.8M
-55%
2024
$826K

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 14% of total spending.

D2930Top 25%

Prefabricated stainless steel crown, primary tooth

$1.1M

7,262 claims · 14.2%

Your Cost: $155.78/claim|Median: $120.85
1.3× median
D1120Normal range

Prophylaxis, adult

$1.0M

26K claims · 12.7%

Your Cost: $39.37/claim|Median: $33.86
1.2× median
D9223Top 5%

Deep sedation/general anesthesia, each additional 15 min

$702K

1,218 claims · 8.8%

Your Cost: $576.24/claim|Median: $107.14
5.4× median
D0120Normal range

Periodic oral evaluation, established patient

$620K

23K claims · 7.8%

Your Cost: $27.27/claim|Median: $24.34
1.1× median
D1208Top 10%

Topical application of fluoride, excluding varnish

$584K

23K claims · 7.3%

Your Cost: $24.97/claim|Median: $14.36
1.7× median
D1351Top 10%

Sealant, per tooth

$471K

8,730 claims · 5.9%

Your Cost: $53.99/claim|Median: $26.10
2.1× median
D9110Top 25%

$433K

8,001 claims · 5.4%

Your Cost: $54.08/claim|Median: $38.08
1.4× median
D7140Normal range

Extraction, erupted tooth or exposed root

$421K

6,551 claims · 5.3%

Your Cost: $64.29/claim|Median: $57.39
1.1× median
D9230Top 25%

Inhalation of nitrous oxide/analgesia, anxiolysis

$384K

10K claims · 4.8%

Your Cost: $36.77/claim|Median: $26.24
1.4× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$310K

34K claims · 3.9%

Your Cost: $9.25/claim|Median: $7.33
1.3× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$295K

4,901 claims · 3.7%

Your Cost: $60.15/claim|Median: $71.00
0.8× median
D1354Top 25%

$265K

7,243 claims · 3.3%

Your Cost: $36.57/claim|Median: $12.52
2.9× median
D3220Normal range

Therapeutic pulpotomy

$242K

2,916 claims · 3.1%

Your Cost: $83.15/claim|Median: $81.27
1.0× median
D9222Top 10%

Deep sedation/general anesthesia, first 15 minutes

$183K

1,201 claims · 2.3%

Your Cost: $152.59/claim|Median: $90.28
1.7× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$162K

7,539 claims · 2.0%

Your Cost: $21.51/claim|Median: $32.07
0.7× median
D0220Normal range

Intraoral periapical radiographic image, first film

$153K

27K claims · 1.9%

Your Cost: $5.78/claim|Median: $10.51
0.5× median
D2391Normal range

Resin-based composite, one surface, posterior

$139K

3,688 claims · 1.7%

Your Cost: $37.66/claim|Median: $54.60
0.7× median
D1510Normal range

$139K

1,680 claims · 1.7%

Your Cost: $82.58/claim|Median: $147.00
0.6× median
D0140Normal range

Limited oral evaluation, problem focused

$66K

3,988 claims · 0.8%

Your Cost: $16.46/claim|Median: $27.07
0.6× median
D2335Top 25%

$55K

375 claims · 0.7%

Your Cost: $146.77/claim|Median: $105.06
1.4× median
D2330Normal range

Resin-based composite filling, one surface, anterior

$38K

726 claims · 0.5%

Your Cost: $53.01/claim|Median: $66.63
0.8× median
D0330Normal range

Panoramic radiographic image

$38K

1,667 claims · 0.5%

Your Cost: $22.85/claim|Median: $37.36
0.6× median
D0274Normal range

Bitewings, four radiographic images

$29K

1,903 claims · 0.4%

Your Cost: $15.44/claim|Median: $22.54
0.7× median
D0272Normal range

Bitewings, two radiographic images

$21K

2,209 claims · 0.3%

Your Cost: $9.58/claim|Median: $15.81
0.6× median
D8670Normal range

Periodic orthodontic treatment visit

$16K

96 claims · 0.2%

Your Cost: $162.50/claim|Median: $185.01
0.9× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$10K

124 claims · 0.1%

Your Cost: $77.95/claim|Median: $84.26
0.9× median
D9995Normal range

$8K

705 claims · 0.1%

Your Cost: $11.02/claim|Median: $13.12
0.8× median
D2332Top 5%

$6K

39 claims · 0.1%

Your Cost: $150.53/claim|Median: $87.21
1.7× median
D2331Normal range

Resin-based composite filling, two surfaces, anterior

$5K

62 claims · 0.1%

Your Cost: $81.73/claim|Median: $73.58
1.1× median
D9310Normal range

$5K

278 claims · 0.1%

Your Cost: $16.85/claim|Median: $46.20
0.4× median
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