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Provider 1124522495

NPI: 1124522495Share
Active Billing Period:2019-03→2024-12(66 months)

Total Paid

$13.8M

$13,763,036

Total Claims

27K

Beneficiaries

19K

1.4 claims/patient

Avg Cost/Claim

$511

Monthly Spending Trend

Yearly Spending

2019
$322K
+423%
2020
$1.7M
+50%
2021
$2.5M
+21%
2022
$3.1M
+7%
2023
$3.3M
-12%
2024
$2.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 18 distinct procedure codes. The top code (D9999 (Unspecified adjunctive procedure, by report)) accounts for 36% of total spending.

D9999Top 1%

Unspecified adjunctive procedure, by report

$4.9M

4,811 claims · 35.6%

Your Cost: $1,017.36/claim|Median: $37.60
27.1× median
41899Top 25%

Unlisted procedure, dentoalveolar structures

$4.3M

2,646 claims · 30.9%

Your Cost: $1,607.99/claim|Median: $763.43
2.1× median
G0330Normal range

$1.1M

642 claims · 7.7%

Your Cost: $1,650.13/claim|Median: $1,205.70
1.4× median
D0150Top 1%

Comprehensive oral evaluation, new or established patient

$844K

2,684 claims · 6.1%

Your Cost: $314.53/claim|Median: $32.07
9.8× median
D7140Top 1%

Extraction, erupted tooth or exposed root

$774K

4,007 claims · 5.6%

Your Cost: $193.07/claim|Median: $57.39
3.4× median
D2930Top 5%

Prefabricated stainless steel crown, primary tooth

$498K

1,584 claims · 3.6%

Your Cost: $314.22/claim|Median: $120.85
2.6× median
00170Normal range

Anesthesia for intraoral procedures

$465K

5,199 claims · 3.4%

Your Cost: $89.35/claim|Median: $132.89
0.7× median
D7240Top 5%

Extraction, impacted tooth, complete bony

$387K

967 claims · 2.8%

Your Cost: $399.73/claim|Median: $231.00
1.7× median
D2934Top 10%

$124K

517 claims · 0.9%

Your Cost: $239.74/claim|Median: $143.67
1.7× median
D3220Top 5%

Therapeutic pulpotomy

$117K

871 claims · 0.9%

Your Cost: $134.54/claim|Median: $81.27
1.7× median
D0603Top 1%

$92K

66 claims · 0.7%

Your Cost: $1,396.12/claim|Median: $6.54
213.5× median
D2392Top 5%

Resin-based composite, two surfaces, posterior

$72K

439 claims · 0.5%

Your Cost: $164.10/claim|Median: $71.00
2.3× median
D0210Normal range

Intraoral, complete series of radiographic images

$72K

1,365 claims · 0.5%

Your Cost: $52.49/claim|Median: $46.33
1.1× median
D2391Top 5%

Resin-based composite, one surface, posterior

$46K

388 claims · 0.3%

Your Cost: $119.34/claim|Median: $54.60
2.2× median
D2330Top 5%

Resin-based composite filling, one surface, anterior

$41K

377 claims · 0.3%

Your Cost: $107.48/claim|Median: $66.63
1.6× median
D7230Top 25%

Extraction, impacted tooth, partial bony

$14K

61 claims · 0.1%

Your Cost: $224.07/claim|Median: $187.09
1.2× median
D1351Normal range

Sealant, per tooth

$7K

271 claims · 0.0%

Your Cost: $24.62/claim|Median: $26.10
0.9× median
D2331Top 25%

Resin-based composite filling, two surfaces, anterior

$4K

37 claims · 0.0%

Your Cost: $98.57/claim|Median: $73.58
1.3× median
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