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Provider 1104880863

NPI: 1104880863Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$10.9M

$10,900,138

Total Claims

210K

Beneficiaries

172K

1.2 claims/patient

Avg Cost/Claim

$52

Monthly Spending Trend

Yearly Spending

2018
$1.6M
-2%
2019
$1.6M
-24%
2020
$1.2M
+39%
2021
$1.7M
+13%
2022
$1.9M
-10%
2023
$1.7M
-36%
2024
$1.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (D2740 (Crown, porcelain/ceramic substrate)) accounts for 23% of total spending.

D2740Normal range

Crown, porcelain/ceramic substrate

$2.5M

5,509 claims · 23.3%

Your Cost: $460.94/claim|Median: $509.58
0.9× median
D3330Normal range

Endodontic therapy, molar (excluding final restoration)

$861K

1,452 claims · 7.9%

Your Cost: $592.65/claim|Median: $463.40
1.3× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$651K

8,651 claims · 6.0%

Your Cost: $75.21/claim|Median: $71.00
1.1× median
D8670Normal range

Periodic orthodontic treatment visit

$606K

10K claims · 5.6%

Your Cost: $60.42/claim|Median: $185.01
0.3× median
D2954Top 25%

$556K

4,983 claims · 5.1%

Your Cost: $111.57/claim|Median: $104.95
1.1× median
D7210Normal range

Extraction, erupted tooth, surgical approach

$498K

6,919 claims · 4.6%

Your Cost: $72.02/claim|Median: $109.42
0.7× median
D1110Normal range

Prophylaxis, adult cleaning

$455K

12K claims · 4.2%

Your Cost: $38.35/claim|Median: $43.38
0.9× median
D1120Normal range

Prophylaxis, adult

$405K

15K claims · 3.7%

Your Cost: $26.76/claim|Median: $33.86
0.8× median
D0120Normal range

Periodic oral evaluation, established patient

$397K

20K claims · 3.6%

Your Cost: $19.68/claim|Median: $24.34
0.8× median
D8080Normal range

Comprehensive orthodontic treatment, adolescent dentition

$391K

456 claims · 3.6%

Your Cost: $856.86/claim|Median: $968.00
0.9× median
D1208Normal range

Topical application of fluoride, excluding varnish

$321K

22K claims · 2.9%

Your Cost: $14.82/claim|Median: $14.36
1.0× median
D1351Normal range

Sealant, per tooth

$304K

16K claims · 2.8%

Your Cost: $18.92/claim|Median: $26.10
0.7× median
D0210Normal range

Intraoral, complete series of radiographic images

$279K

5,089 claims · 2.6%

Your Cost: $54.90/claim|Median: $46.33
1.2× median
D0330Normal range

Panoramic radiographic image

$269K

8,360 claims · 2.5%

Your Cost: $32.12/claim|Median: $37.36
0.9× median
D3320Top 25%

$254K

534 claims · 2.3%

Your Cost: $475.60/claim|Median: $365.40
1.3× median
D8680Top 5%

$238K

219 claims · 2.2%

Your Cost: $1,088.41/claim|Median: $174.00
6.3× median
D4341Normal range

Periodontal scaling, per quadrant

$232K

3,132 claims · 2.1%

Your Cost: $73.96/claim|Median: $70.00
1.1× median
D0140Normal range

Limited oral evaluation, problem focused

$224K

11K claims · 2.1%

Your Cost: $19.84/claim|Median: $27.07
0.7× median
D2930Normal range

Prefabricated stainless steel crown, primary tooth

$221K

2,298 claims · 2.0%

Your Cost: $96.06/claim|Median: $120.85
0.8× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$181K

2,119 claims · 1.7%

Your Cost: $85.41/claim|Median: $84.26
1.0× median
D0274Normal range

Bitewings, four radiographic images

$140K

8,613 claims · 1.3%

Your Cost: $16.28/claim|Median: $22.54
0.7× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$114K

4,867 claims · 1.0%

Your Cost: $23.49/claim|Median: $32.07
0.7× median
D9310Normal range

$96K

4,225 claims · 0.9%

Your Cost: $22.63/claim|Median: $46.20
0.5× median
D7140Normal range

Extraction, erupted tooth or exposed root

$91K

1,877 claims · 0.8%

Your Cost: $48.68/claim|Median: $57.39
0.8× median
D2391Normal range

Resin-based composite, one surface, posterior

$88K

1,567 claims · 0.8%

Your Cost: $56.20/claim|Median: $54.60
1.0× median
D4910Normal range

$71K

1,206 claims · 0.6%

Your Cost: $58.60/claim|Median: $75.56
0.8× median
D9230Normal range

Inhalation of nitrous oxide/analgesia, anxiolysis

$65K

4,790 claims · 0.6%

Your Cost: $13.49/claim|Median: $26.24
0.5× median
D3220Normal range

Therapeutic pulpotomy

$60K

966 claims · 0.5%

Your Cost: $61.92/claim|Median: $81.27
0.8× median
D0220Normal range

Intraoral periapical radiographic image, first film

$58K

9,635 claims · 0.5%

Your Cost: $6.01/claim|Median: $10.51
0.6× median
D0272Normal range

Bitewings, two radiographic images

$54K

4,688 claims · 0.5%

Your Cost: $11.58/claim|Median: $15.81
0.7× median
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