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Provider 1114392107

NPI: 1114392107Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$7.8M

$7,789,712

Total Claims

289K

Beneficiaries

253K

1.1 claims/patient

Avg Cost/Claim

$27

Monthly Spending Trend

Yearly Spending

2018
$651K
-8%
2019
$599K
+60%
2020
$955K
+70%
2021
$1.6M
-6%
2022
$1.5M
-19%
2023
$1.2M
-4%
2024
$1.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 27 distinct procedure codes. The top code (D2930 (Prefabricated stainless steel crown, primary tooth)) accounts for 13% of total spending.

D2930Normal range

Prefabricated stainless steel crown, primary tooth

$1.0M

9,934 claims · 12.9%

Your Cost: $101.31/claim|Median: $120.85
0.8× median
D1120Normal range

Prophylaxis, adult

$969K

37K claims · 12.4%

Your Cost: $26.22/claim|Median: $33.86
0.8× median
D0120Normal range

Periodic oral evaluation, established patient

$720K

41K claims · 9.2%

Your Cost: $17.65/claim|Median: $24.34
0.7× median
D1999Top 10%

$696K

38K claims · 8.9%

Your Cost: $18.45/claim|Median: $11.95
1.5× median
D1206Normal range

Topical application of fluoride varnish

$643K

31K claims · 8.3%

Your Cost: $20.54/claim|Median: $18.12
1.1× median
D2391Normal range

Resin-based composite, one surface, posterior

$515K

8,404 claims · 6.6%

Your Cost: $61.33/claim|Median: $54.60
1.1× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$511K

6,895 claims · 6.6%

Your Cost: $74.15/claim|Median: $71.00
1.0× median
D7140Normal range

Extraction, erupted tooth or exposed root

$440K

8,290 claims · 5.6%

Your Cost: $53.02/claim|Median: $57.39
0.9× median
D9230Normal range

Inhalation of nitrous oxide/analgesia, anxiolysis

$394K

19K claims · 5.1%

Your Cost: $20.31/claim|Median: $26.24
0.8× median
D0330Normal range

Panoramic radiographic image

$367K

9,215 claims · 4.7%

Your Cost: $39.78/claim|Median: $37.36
1.1× median
D0272Normal range

Bitewings, two radiographic images

$280K

18K claims · 3.6%

Your Cost: $15.89/claim|Median: $15.81
1.0× median
D1208Normal range

Topical application of fluoride, excluding varnish

$267K

19K claims · 3.4%

Your Cost: $13.84/claim|Median: $14.36
1.0× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$250K

11K claims · 3.2%

Your Cost: $23.25/claim|Median: $32.07
0.7× median
D1110Normal range

Prophylaxis, adult cleaning

$232K

6,850 claims · 3.0%

Your Cost: $33.87/claim|Median: $43.38
0.8× median
D1354Normal range

$110K

4,750 claims · 1.4%

Your Cost: $23.23/claim|Median: $12.52
1.9× median
D0140Normal range

Limited oral evaluation, problem focused

$93K

3,553 claims · 1.2%

Your Cost: $26.15/claim|Median: $27.07
1.0× median
D0274Normal range

Bitewings, four radiographic images

$88K

4,144 claims · 1.1%

Your Cost: $21.27/claim|Median: $22.54
0.9× median
D1351Normal range

Sealant, per tooth

$77K

3,342 claims · 1.0%

Your Cost: $23.17/claim|Median: $26.10
0.9× median
D0220Normal range

Intraoral periapical radiographic image, first film

$58K

5,761 claims · 0.7%

Your Cost: $10.00/claim|Median: $10.51
1.0× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$18K

1,999 claims · 0.2%

Your Cost: $8.80/claim|Median: $7.33
1.2× median
D7240Normal range

Extraction, impacted tooth, complete bony

$13K

75 claims · 0.2%

Your Cost: $172.43/claim|Median: $231.00
0.7× median
D0240Normal range

$12K

723 claims · 0.2%

Your Cost: $16.33/claim|Median: $15.24
1.1× median
D3220Normal range

Therapeutic pulpotomy

$10K

134 claims · 0.1%

Your Cost: $75.88/claim|Median: $81.27
0.9× median
D2330Normal range

Resin-based composite filling, one surface, anterior

$8K

140 claims · 0.1%

Your Cost: $58.46/claim|Median: $66.63
0.9× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$7K

82 claims · 0.1%

Your Cost: $80.92/claim|Median: $84.26
1.0× median
D3120Normal range

$6K

720 claims · 0.1%

Your Cost: $8.52/claim|Median: $24.98
0.3× median
D0270Normal range

$0

377 claims · 0.0%

Your Cost: $0.00/claim|Median: $5.46
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