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Provider 1104937010

NPI: 1104937010Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$16.8M

$16,835,148

Total Claims

551K

Beneficiaries

462K

1.2 claims/patient

Avg Cost/Claim

$31

Monthly Spending Trend

Yearly Spending

2018
$2.7M
+8%
2019
$2.9M
-29%
2020
$2.1M
+4%
2021
$2.2M
+11%
2022
$2.4M
-6%
2023
$2.2M
+4%
2024
$2.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 24 distinct procedure codes. The top code (D0120 (Periodic oral evaluation, established patient)) accounts for 14% of total spending.

D0120Normal range

Periodic oral evaluation, established patient

$2.4M

92K claims · 14.1%

Your Cost: $25.90/claim|Median: $24.34
1.1× median
D1120Normal range

Prophylaxis, adult

$1.9M

69K claims · 11.0%

Your Cost: $26.94/claim|Median: $33.86
0.8× median
D1351Normal range

Sealant, per tooth

$1.8M

65K claims · 10.8%

Your Cost: $27.74/claim|Median: $26.10
1.1× median
D2392Top 25%

Resin-based composite, two surfaces, posterior

$1.8M

17K claims · 10.7%

Your Cost: $103.01/claim|Median: $71.00
1.5× median
D1208Normal range

Topical application of fluoride, excluding varnish

$1.6M

99K claims · 9.7%

Your Cost: $16.50/claim|Median: $14.36
1.1× median
D1110Normal range

Prophylaxis, adult cleaning

$1.2M

32K claims · 7.3%

Your Cost: $38.01/claim|Median: $43.38
0.9× median
D7140Normal range

Extraction, erupted tooth or exposed root

$996K

16K claims · 5.9%

Your Cost: $61.68/claim|Median: $57.39
1.1× median
D0330Top 25%

Panoramic radiographic image

$660K

12K claims · 3.9%

Your Cost: $56.09/claim|Median: $37.36
1.5× median
D2391Top 25%

Resin-based composite, one surface, posterior

$643K

8,357 claims · 3.8%

Your Cost: $76.89/claim|Median: $54.60
1.4× median
D0272Normal range

Bitewings, two radiographic images

$610K

34K claims · 3.6%

Your Cost: $18.03/claim|Median: $15.81
1.1× median
D9230Top 25%

Inhalation of nitrous oxide/analgesia, anxiolysis

$607K

14K claims · 3.6%

Your Cost: $42.68/claim|Median: $26.24
1.6× median
D0274Top 25%

Bitewings, four radiographic images

$566K

18K claims · 3.4%

Your Cost: $31.71/claim|Median: $22.54
1.4× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$387K

9,507 claims · 2.3%

Your Cost: $40.74/claim|Median: $32.07
1.3× median
D0220Top 25%

Intraoral periapical radiographic image, first film

$343K

24K claims · 2.0%

Your Cost: $14.43/claim|Median: $10.51
1.4× median
D0140Top 25%

Limited oral evaluation, problem focused

$273K

7,466 claims · 1.6%

Your Cost: $36.62/claim|Median: $27.07
1.4× median
D7111Normal range

$232K

4,708 claims · 1.4%

Your Cost: $49.28/claim|Median: $49.49
1.0× median
D0230Top 25%

Intraoral, periapical radiographic image, first film

$197K

17K claims · 1.2%

Your Cost: $11.45/claim|Median: $7.33
1.6× median
D2930Normal range

Prefabricated stainless steel crown, primary tooth

$171K

1,250 claims · 1.0%

Your Cost: $136.67/claim|Median: $120.85
1.1× median
D2393Top 25%

Resin-based composite, three surfaces, posterior

$169K

1,413 claims · 1.0%

Your Cost: $119.54/claim|Median: $84.26
1.4× median
D0240Normal range

$119K

7,207 claims · 0.7%

Your Cost: $16.52/claim|Median: $15.24
1.1× median
D3220Normal range

Therapeutic pulpotomy

$76K

948 claims · 0.5%

Your Cost: $80.07/claim|Median: $81.27
1.0× median
D1510Normal range

$72K

407 claims · 0.4%

Your Cost: $176.93/claim|Median: $147.00
1.2× median
D2330Normal range

Resin-based composite filling, one surface, anterior

$8K

160 claims · 0.0%

Your Cost: $50.70/claim|Median: $66.63
0.8× median
D9986Normal range

$0

61 claims · 0.0%

Your Cost: $0.00/claim|Median: $1.04
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