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Provider 1184194433

NPI: 1184194433Share
Active Billing Period:2019-03→2024-12(70 months)

Total Paid

$11.0M

$11,012,802

Total Claims

165K

Beneficiaries

104K

1.6 claims/patient

Avg Cost/Claim

$67

Monthly Spending Trend

Yearly Spending

2019
$694K
+120%
2020
$1.5M
+91%
2021
$2.9M
-17%
2022
$2.4M
-18%
2023
$2.0M
-26%
2024
$1.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (D2930 (Prefabricated stainless steel crown, primary tooth)) accounts for 32% of total spending.

D2930Top 10%

Prefabricated stainless steel crown, primary tooth

$3.5M

18K claims · 31.5%

Your Cost: $194.22/claim|Median: $120.85
1.6× median
D2392Top 10%

Resin-based composite, two surfaces, posterior

$1.1M

9,399 claims · 10.4%

Your Cost: $121.37/claim|Median: $71.00
1.7× median
D3220Top 10%

Therapeutic pulpotomy

$1.1M

8,390 claims · 9.7%

Your Cost: $126.69/claim|Median: $81.27
1.6× median
D7140Top 25%

Extraction, erupted tooth or exposed root

$790K

9,287 claims · 7.2%

Your Cost: $85.06/claim|Median: $57.39
1.5× median
D1120Top 25%

Prophylaxis, adult

$615K

15K claims · 5.6%

Your Cost: $40.13/claim|Median: $33.86
1.2× median
D2390Normal range

$423K

2,123 claims · 3.8%

Your Cost: $199.04/claim|Median: $170.27
1.2× median
D1206Top 25%

Topical application of fluoride varnish

$409K

15K claims · 3.7%

Your Cost: $27.06/claim|Median: $18.12
1.5× median
D0120Top 25%

Periodic oral evaluation, established patient

$358K

11K claims · 3.3%

Your Cost: $32.26/claim|Median: $24.34
1.3× median
D1354Top 25%

$300K

11K claims · 2.7%

Your Cost: $27.42/claim|Median: $12.52
2.2× median
D0230Top 25%

Intraoral, periapical radiographic image, first film

$293K

24K claims · 2.7%

Your Cost: $12.43/claim|Median: $7.33
1.7× median
D2393Top 25%

Resin-based composite, three surfaces, posterior

$265K

1,869 claims · 2.4%

Your Cost: $141.79/claim|Median: $84.26
1.7× median
D9920Normal range

$249K

5,625 claims · 2.3%

Your Cost: $44.33/claim|Median: $44.88
1.0× median
D9310Top 25%

$188K

2,712 claims · 1.7%

Your Cost: $69.19/claim|Median: $46.20
1.5× median
D2332Top 25%

$182K

1,439 claims · 1.7%

Your Cost: $126.73/claim|Median: $87.21
1.5× median
D1510Top 25%

$181K

924 claims · 1.6%

Your Cost: $196.00/claim|Median: $147.00
1.3× median
D0220Top 5%

Intraoral periapical radiographic image, first film

$172K

9,863 claims · 1.6%

Your Cost: $17.41/claim|Median: $10.51
1.7× median
D2330Top 25%

Resin-based composite filling, one surface, anterior

$149K

1,782 claims · 1.4%

Your Cost: $83.83/claim|Median: $66.63
1.3× median
D2391Top 25%

Resin-based composite, one surface, posterior

$122K

1,363 claims · 1.1%

Your Cost: $89.87/claim|Median: $54.60
1.6× median
D0150Top 25%

Comprehensive oral evaluation, new or established patient

$109K

1,985 claims · 1.0%

Your Cost: $55.11/claim|Median: $32.07
1.7× median
D0140Top 5%

Limited oral evaluation, problem focused

$97K

1,651 claims · 0.9%

Your Cost: $58.59/claim|Median: $27.07
2.2× median
D1351Normal range

Sealant, per tooth

$92K

3,051 claims · 0.8%

Your Cost: $30.10/claim|Median: $26.10
1.2× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$62K

1,571 claims · 0.6%

Your Cost: $39.52/claim|Median: $57.30
0.7× median
D0272Top 10%

Bitewings, two radiographic images

$62K

2,607 claims · 0.6%

Your Cost: $23.76/claim|Median: $15.81
1.5× median
D0330Top 10%

Panoramic radiographic image

$43K

631 claims · 0.4%

Your Cost: $67.60/claim|Median: $37.36
1.8× median
D9248Normal range

$38K

728 claims · 0.3%

Your Cost: $52.75/claim|Median: $92.49
0.6× median
D0210Normal range

Intraoral, complete series of radiographic images

$37K

740 claims · 0.3%

Your Cost: $50.59/claim|Median: $46.33
1.1× median
D0240Normal range

$35K

1,865 claims · 0.3%

Your Cost: $18.94/claim|Median: $15.24
1.2× median
D9420Normal range

$35K

327 claims · 0.3%

Your Cost: $105.61/claim|Median: $81.82
1.3× median
D2934Top 25%

$24K

109 claims · 0.2%

Your Cost: $223.76/claim|Median: $143.67
1.6× median
D2920Normal range

$4K

94 claims · 0.0%

Your Cost: $41.58/claim|Median: $37.48
1.1× median
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