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Provider 1104999481

NPI: 1104999481Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$8.3M

$8,340,620

Total Claims

251K

Beneficiaries

215K

1.2 claims/patient

Avg Cost/Claim

$33

Monthly Spending Trend

Yearly Spending

2018
$538K
+223%
2019
$1.7M
-45%
2020
$949K
+51%
2021
$1.4M
-2%
2022
$1.4M
-4%
2023
$1.3M
-29%
2024
$952K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (D1110 (Prophylaxis, adult cleaning)) accounts for 18% of total spending.

D1110Normal range

Prophylaxis, adult cleaning

$1.5M

35K claims · 18.2%

Your Cost: $43.82/claim|Median: $43.38
1.0× median
D9410Normal range

$867K

34K claims · 10.4%

Your Cost: $25.18/claim|Median: $28.00
0.9× median
D0120Normal range

Periodic oral evaluation, established patient

$750K

29K claims · 9.0%

Your Cost: $26.09/claim|Median: $24.34
1.1× median
D1206Normal range

Topical application of fluoride varnish

$573K

24K claims · 6.9%

Your Cost: $24.18/claim|Median: $18.12
1.3× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$517K

8,057 claims · 6.2%

Your Cost: $64.12/claim|Median: $71.00
0.9× median
D0274Top 25%

Bitewings, four radiographic images

$489K

14K claims · 5.9%

Your Cost: $33.75/claim|Median: $22.54
1.5× median
D0330Top 10%

Panoramic radiographic image

$399K

6,045 claims · 4.8%

Your Cost: $66.04/claim|Median: $37.36
1.8× median
D2391Normal range

Resin-based composite, one surface, posterior

$373K

7,516 claims · 4.5%

Your Cost: $49.58/claim|Median: $54.60
0.9× median
D0140Normal range

Limited oral evaluation, problem focused

$300K

10K claims · 3.6%

Your Cost: $28.92/claim|Median: $27.07
1.1× median
D7140Top 25%

Extraction, erupted tooth or exposed root

$276K

3,466 claims · 3.3%

Your Cost: $79.71/claim|Median: $57.39
1.4× median
D1120Normal range

Prophylaxis, adult

$270K

8,886 claims · 3.2%

Your Cost: $30.34/claim|Median: $33.86
0.9× median
D1354Top 25%

$269K

8,455 claims · 3.2%

Your Cost: $31.86/claim|Median: $12.52
2.5× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$261K

9,357 claims · 3.1%

Your Cost: $27.94/claim|Median: $32.07
0.9× median
D0220Top 25%

Intraoral periapical radiographic image, first film

$182K

15K claims · 2.2%

Your Cost: $12.37/claim|Median: $10.51
1.2× median
D2331Normal range

Resin-based composite filling, two surfaces, anterior

$160K

2,238 claims · 1.9%

Your Cost: $71.28/claim|Median: $73.58
1.0× median
D2150Top 25%

Amalgam, two surfaces, primary or permanent

$152K

1,799 claims · 1.8%

Your Cost: $84.54/claim|Median: $66.00
1.3× median
D1351Normal range

Sealant, per tooth

$143K

6,384 claims · 1.7%

Your Cost: $22.34/claim|Median: $26.10
0.9× median
D2330Normal range

Resin-based composite filling, one surface, anterior

$103K

1,883 claims · 1.2%

Your Cost: $54.94/claim|Median: $66.63
0.8× median
D2335Normal range

$87K

963 claims · 1.0%

Your Cost: $90.43/claim|Median: $105.06
0.9× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$82K

11K claims · 1.0%

Your Cost: $7.36/claim|Median: $7.33
1.0× median
D2160Top 10%

Amalgam filling, three surfaces

$77K

732 claims · 0.9%

Your Cost: $105.23/claim|Median: $78.55
1.3× median
D2332Normal range

$71K

864 claims · 0.9%

Your Cost: $82.45/claim|Median: $87.21
0.9× median
D5110Top 25%

$62K

90 claims · 0.7%

Your Cost: $692.98/claim|Median: $472.15
1.5× median
D7210Normal range

Extraction, erupted tooth, surgical approach

$61K

656 claims · 0.7%

Your Cost: $92.37/claim|Median: $109.42
0.8× median
D2140Top 25%

Amalgam, one surface, primary or permanent

$57K

860 claims · 0.7%

Your Cost: $66.30/claim|Median: $52.77
1.3× median
D0272Top 25%

Bitewings, two radiographic images

$57K

2,674 claims · 0.7%

Your Cost: $21.27/claim|Median: $15.81
1.3× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$49K

850 claims · 0.6%

Your Cost: $57.13/claim|Median: $84.26
0.7× median
D5120Top 25%

$38K

52 claims · 0.5%

Your Cost: $725.30/claim|Median: $468.71
1.5× median
D9230Normal range

Inhalation of nitrous oxide/analgesia, anxiolysis

$36K

2,383 claims · 0.4%

Your Cost: $15.06/claim|Median: $26.24
0.6× median
D1330Top 5%

$30K

1,144 claims · 0.4%

Your Cost: $26.61/claim|Median: $5.73
4.6× median
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