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Provider 1174503080

NPI: 1174503080Share
Active Billing Period:2018-04→2024-11(71 months)

Total Paid

$11.7M

$11,746,921

Total Claims

24K

Beneficiaries

15K

1.5 claims/patient

Avg Cost/Claim

$498

Monthly Spending Trend

Yearly Spending

2018
$39K
+3499%
2019
$1.4M
+88%
2020
$2.7M
-10%
2021
$2.4M
-12%
2022
$2.1M
-3%
2023
$2.0M
-47%
2024
$1.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 14 distinct procedure codes. The top code (D2930 (Prefabricated stainless steel crown, primary tooth)) accounts for 80% of total spending.

D2930Top 1%

Prefabricated stainless steel crown, primary tooth

$9.4M

7,236 claims · 80.1%

Your Cost: $1,300.45/claim|Median: $120.85
10.8× median
D7140Top 1%

Extraction, erupted tooth or exposed root

$744K

3,861 claims · 6.3%

Your Cost: $192.73/claim|Median: $57.39
3.4× median
D2335Top 1%

$720K

1,851 claims · 6.1%

Your Cost: $388.81/claim|Median: $105.06
3.7× median
D2391Top 1%

Resin-based composite, one surface, posterior

$661K

1,719 claims · 5.6%

Your Cost: $384.77/claim|Median: $54.60
7.0× median
D2392Top 1%

Resin-based composite, two surfaces, posterior

$107K

288 claims · 0.9%

Your Cost: $371.02/claim|Median: $71.00
5.2× median
99499Top 1%

Unlisted evaluation and management service

$47K

54 claims · 0.4%

Your Cost: $869.28/claim|Median: $30.88
28.2× median
D3220Normal range

Therapeutic pulpotomy

$34K

1,913 claims · 0.3%

Your Cost: $17.88/claim|Median: $81.27
0.2× median
D2330Top 1%

Resin-based composite filling, one surface, anterior

$17K

85 claims · 0.1%

Your Cost: $195.16/claim|Median: $66.63
2.9× median
D0220Normal range

Intraoral periapical radiographic image, first film

$4K

1,191 claims · 0.0%

Your Cost: $3.08/claim|Median: $10.51
0.3× median
D0272Normal range

Bitewings, two radiographic images

$2K

2,924 claims · 0.0%

Your Cost: $0.75/claim|Median: $15.81
0.0× median
D1510Normal range

$885

912 claims · 0.0%

Your Cost: $0.97/claim|Median: $147.00
0.0× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$252

625 claims · 0.0%

Your Cost: $0.40/claim|Median: $7.33
0.1× median
D1351Normal range

Sealant, per tooth

$58

881 claims · 0.0%

Your Cost: $0.07/claim|Median: $26.10
0.0× median
D2332Normal range

$0

36 claims · 0.0%

Your Cost: $0.00/claim|Median: $87.21
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