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Provider 1053415679

NPI: 1053415679Share
Active Billing Period:2018-01→2024-12(83 months)

Total Paid

$17.4M

$17,355,314

Total Claims

568K

Beneficiaries

322K

1.8 claims/patient

Avg Cost/Claim

$31

Monthly Spending Trend

Yearly Spending

2018
$1.7M
+26%
2019
$2.1M
-36%
2020
$1.4M
+29%
2021
$1.8M
+73%
2022
$3.1M
+25%
2023
$3.8M
-8%
2024
$3.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (D0120 (Periodic oral evaluation, established patient)) accounts for 13% of total spending.

D0120Top 10%

Periodic oral evaluation, established patient

$2.2M

38K claims · 12.8%

Your Cost: $57.80/claim|Median: $24.34
2.4× median
D1120Top 25%

Prophylaxis, adult

$1.7M

43K claims · 9.9%

Your Cost: $40.14/claim|Median: $33.86
1.2× median
D2751Normal range

Crown, porcelain fused to predominantly base metal

$1.6M

3,342 claims · 9.1%

Your Cost: $474.74/claim|Median: $476.00
1.0× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$1.1M

251K claims · 6.1%

Your Cost: $4.20/claim|Median: $7.33
0.6× median
D2930Normal range

Prefabricated stainless steel crown, primary tooth

$823K

6,950 claims · 4.7%

Your Cost: $118.43/claim|Median: $120.85
1.0× median
D3220Top 25%

Therapeutic pulpotomy

$771K

7,823 claims · 4.4%

Your Cost: $98.58/claim|Median: $81.27
1.2× median
D0150Top 10%

Comprehensive oral evaluation, new or established patient

$770K

12K claims · 4.4%

Your Cost: $64.17/claim|Median: $32.07
2.0× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$743K

11K claims · 4.3%

Your Cost: $66.77/claim|Median: $71.00
0.9× median
D1208Normal range

Topical application of fluoride, excluding varnish

$698K

47K claims · 4.0%

Your Cost: $14.73/claim|Median: $14.36
1.0× median
D3330Normal range

Endodontic therapy, molar (excluding final restoration)

$585K

1,267 claims · 3.4%

Your Cost: $461.39/claim|Median: $463.40
1.0× median
D7111Normal range

$556K

9,718 claims · 3.2%

Your Cost: $57.18/claim|Median: $49.49
1.2× median
D2150Normal range

Amalgam, two surfaces, primary or permanent

$512K

7,774 claims · 3.0%

Your Cost: $65.92/claim|Median: $66.00
1.0× median
D1310Normal range

Nutritional counseling for control of dental disease

$496K

11K claims · 2.9%

Your Cost: $44.65/claim|Median: $40.52
1.1× median
D0272Normal range

Bitewings, two radiographic images

$468K

40K claims · 2.7%

Your Cost: $11.79/claim|Median: $15.81
0.7× median
D8670Top 25%

Periodic orthodontic treatment visit

$443K

1,585 claims · 2.6%

Your Cost: $279.34/claim|Median: $185.01
1.5× median
D7210Normal range

Extraction, erupted tooth, surgical approach

$433K

3,708 claims · 2.5%

Your Cost: $116.86/claim|Median: $109.42
1.1× median
D1351Top 25%

Sealant, per tooth

$369K

11K claims · 2.1%

Your Cost: $33.16/claim|Median: $26.10
1.3× median
D9993Normal range

$300K

4,891 claims · 1.7%

Your Cost: $61.43/claim|Median: $62.07
1.0× median
D7240Normal range

Extraction, impacted tooth, complete bony

$295K

1,277 claims · 1.7%

Your Cost: $230.64/claim|Median: $231.00
1.0× median
D2954Normal range

$291K

2,778 claims · 1.7%

Your Cost: $104.83/claim|Median: $104.95
1.0× median
D9230Top 25%

Inhalation of nitrous oxide/analgesia, anxiolysis

$284K

7,220 claims · 1.6%

Your Cost: $39.37/claim|Median: $26.24
1.5× median
D7230Normal range

Extraction, impacted tooth, partial bony

$237K

1,255 claims · 1.4%

Your Cost: $188.98/claim|Median: $187.09
1.0× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$218K

2,740 claims · 1.3%

Your Cost: $79.40/claim|Median: $84.26
0.9× median
D4341Normal range

Periodontal scaling, per quadrant

$167K

2,497 claims · 1.0%

Your Cost: $66.90/claim|Median: $70.00
1.0× median
D4910Top 10%

$148K

1,797 claims · 0.9%

Your Cost: $82.15/claim|Median: $75.56
1.1× median
D1110Top 10%

Prophylaxis, adult cleaning

$147K

1,717 claims · 0.8%

Your Cost: $85.69/claim|Median: $43.38
2.0× median
D0603Top 25%

$124K

8,467 claims · 0.7%

Your Cost: $14.60/claim|Median: $6.54
2.2× median
D0140Normal range

Limited oral evaluation, problem focused

$111K

3,332 claims · 0.6%

Your Cost: $33.34/claim|Median: $27.07
1.2× median
D0340Normal range

$106K

2,141 claims · 0.6%

Your Cost: $49.63/claim|Median: $49.44
1.0× median
D0330Normal range

Panoramic radiographic image

$96K

3,313 claims · 0.6%

Your Cost: $29.05/claim|Median: $37.36
0.8× median
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