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Provider 1053618801

NPI: 1053618801Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$11.3M

$11,349,003

Total Claims

245K

Beneficiaries

195K

1.3 claims/patient

Avg Cost/Claim

$46

Monthly Spending Trend

Yearly Spending

2018
$1.5M
-0%
2019
$1.5M
-44%
2020
$867K
+101%
2021
$1.7M
-6%
2022
$1.6M
+8%
2023
$1.8M
+29%
2024
$2.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (D7210 (Extraction, erupted tooth, surgical approach)) accounts for 18% of total spending.

D7210Normal range

Extraction, erupted tooth, surgical approach

$2.1M

19K claims · 18.2%

Your Cost: $106.30/claim|Median: $109.42
1.0× median
D2930Normal range

Prefabricated stainless steel crown, primary tooth

$1.1M

8,102 claims · 10.1%

Your Cost: $141.31/claim|Median: $120.85
1.2× median
D2392Top 25%

Resin-based composite, two surfaces, posterior

$1.0M

10K claims · 9.2%

Your Cost: $104.46/claim|Median: $71.00
1.5× median
D0330Top 25%

Panoramic radiographic image

$871K

16K claims · 7.7%

Your Cost: $55.95/claim|Median: $37.36
1.5× median
D0140Normal range

Limited oral evaluation, problem focused

$798K

23K claims · 7.0%

Your Cost: $35.06/claim|Median: $27.07
1.3× median
D0120Normal range

Periodic oral evaluation, established patient

$552K

21K claims · 4.9%

Your Cost: $25.72/claim|Median: $24.34
1.1× median
D7240Normal range

Extraction, impacted tooth, complete bony

$446K

2,451 claims · 3.9%

Your Cost: $181.99/claim|Median: $231.00
0.8× median
D1120Normal range

Prophylaxis, adult

$432K

16K claims · 3.8%

Your Cost: $27.33/claim|Median: $33.86
0.8× median
D7250Normal range

$426K

3,696 claims · 3.7%

Your Cost: $115.14/claim|Median: $112.26
1.0× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$406K

9,758 claims · 3.6%

Your Cost: $41.58/claim|Median: $32.07
1.3× median
D1110Normal range

Prophylaxis, adult cleaning

$379K

10K claims · 3.3%

Your Cost: $37.64/claim|Median: $43.38
0.9× median
D0274Top 25%

Bitewings, four radiographic images

$341K

11K claims · 3.0%

Your Cost: $31.04/claim|Median: $22.54
1.4× median
D0220Top 25%

Intraoral periapical radiographic image, first film

$308K

21K claims · 2.7%

Your Cost: $14.68/claim|Median: $10.51
1.4× median
D9230Top 25%

Inhalation of nitrous oxide/analgesia, anxiolysis

$254K

5,946 claims · 2.2%

Your Cost: $42.78/claim|Median: $26.24
1.6× median
D1206Normal range

Topical application of fluoride varnish

$228K

14K claims · 2.0%

Your Cost: $16.54/claim|Median: $18.12
0.9× median
D1351Normal range

Sealant, per tooth

$186K

6,849 claims · 1.6%

Your Cost: $27.16/claim|Median: $26.10
1.0× median
D0230Top 25%

Intraoral, periapical radiographic image, first film

$181K

16K claims · 1.6%

Your Cost: $11.62/claim|Median: $7.33
1.6× median
D2391Top 25%

Resin-based composite, one surface, posterior

$158K

2,082 claims · 1.4%

Your Cost: $75.80/claim|Median: $54.60
1.4× median
D7230Normal range

Extraction, impacted tooth, partial bony

$141K

879 claims · 1.2%

Your Cost: $160.81/claim|Median: $187.09
0.9× median
D3220Normal range

Therapeutic pulpotomy

$132K

1,635 claims · 1.2%

Your Cost: $80.58/claim|Median: $81.27
1.0× median
D0272Normal range

Bitewings, two radiographic images

$132K

7,152 claims · 1.2%

Your Cost: $18.41/claim|Median: $15.81
1.2× median
D7140Normal range

Extraction, erupted tooth or exposed root

$131K

2,125 claims · 1.2%

Your Cost: $61.47/claim|Median: $57.39
1.1× median
D1208Normal range

Topical application of fluoride, excluding varnish

$125K

7,906 claims · 1.1%

Your Cost: $15.86/claim|Median: $14.36
1.1× median
D7311Normal range

$118K

1,274 claims · 1.0%

Your Cost: $92.90/claim|Median: $91.31
1.0× median
D0240Normal range

$63K

4,000 claims · 0.6%

Your Cost: $15.68/claim|Median: $15.24
1.0× median
D8670Normal range

Periodic orthodontic treatment visit

$61K

976 claims · 0.5%

Your Cost: $62.27/claim|Median: $185.01
0.3× median
D2390Normal range

$60K

366 claims · 0.5%

Your Cost: $163.61/claim|Median: $170.27
1.0× median
D2393Top 25%

Resin-based composite, three surfaces, posterior

$53K

443 claims · 0.5%

Your Cost: $119.89/claim|Median: $84.26
1.4× median
D2150Top 10%

Amalgam, two surfaces, primary or permanent

$38K

415 claims · 0.3%

Your Cost: $90.47/claim|Median: $66.00
1.4× median
D4346Normal range

$35K

892 claims · 0.3%

Your Cost: $38.72/claim|Median: $61.42
0.6× median
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