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Provider 1184691693

NPI: 1184691693Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$18.3M

$18,327,076

Total Claims

307K

Beneficiaries

249K

1.2 claims/patient

Avg Cost/Claim

$60

Monthly Spending Trend

Yearly Spending

2018
$3.1M
+44%
2019
$4.5M
-32%
2020
$3.0M
+1%
2021
$3.1M
-38%
2022
$1.9M
-24%
2023
$1.5M
-11%
2024
$1.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 20% of total spending.

99213Top 5%

Office/outpatient visit, est. patient, low-mod complexity

$3.6M

28K claims · 19.8%

Your Cost: $128.91/claim|Median: $37.81
3.4× median
D1206Top 1%

Topical application of fluoride varnish

$2.2M

42K claims · 12.0%

Your Cost: $52.60/claim|Median: $18.12
2.9× median
D1120Top 1%

Prophylaxis, adult

$1.9M

14K claims · 10.2%

Your Cost: $136.76/claim|Median: $33.86
4.0× median
D1110Top 1%

Prophylaxis, adult cleaning

$1.7M

14K claims · 9.5%

Your Cost: $121.65/claim|Median: $43.38
2.8× median
D0330Top 1%

Panoramic radiographic image

$1.2M

11K claims · 6.6%

Your Cost: $113.30/claim|Median: $37.36
3.0× median
99214Top 5%

Office/outpatient visit, est. patient, mod-high complexity

$1.0M

8,620 claims · 5.7%

Your Cost: $121.36/claim|Median: $53.41
2.3× median
D0150Top 5%

Comprehensive oral evaluation, new or established patient

$646K

9,610 claims · 3.5%

Your Cost: $67.22/claim|Median: $32.07
2.1× median
99212Top 5%

Office/outpatient visit, low complexity

$614K

3,891 claims · 3.3%

Your Cost: $157.78/claim|Median: $25.06
6.3× median
99393Top 5%

Preventive medicine, established patient, age 5-11

$587K

3,344 claims · 3.2%

Your Cost: $175.47/claim|Median: $74.82
2.3× median
D0120Top 5%

Periodic oral evaluation, established patient

$569K

6,714 claims · 3.1%

Your Cost: $84.80/claim|Median: $24.34
3.5× median
99394Top 5%

Preventive medicine, established patient, age 12-17

$524K

2,985 claims · 2.9%

Your Cost: $175.52/claim|Median: $80.15
2.2× median
D7140Top 25%

Extraction, erupted tooth or exposed root

$482K

6,336 claims · 2.6%

Your Cost: $76.13/claim|Median: $57.39
1.3× median
99392Top 5%

Preventive medicine, established patient, age 1-4

$409K

2,340 claims · 2.2%

Your Cost: $174.61/claim|Median: $75.18
2.3× median
D0140Top 5%

Limited oral evaluation, problem focused

$384K

4,038 claims · 2.1%

Your Cost: $95.06/claim|Median: $27.07
3.5× median
D0220Top 25%

Intraoral periapical radiographic image, first film

$295K

22K claims · 1.6%

Your Cost: $13.60/claim|Median: $10.51
1.3× median
D2392Top 10%

Resin-based composite, two surfaces, posterior

$226K

1,711 claims · 1.2%

Your Cost: $132.16/claim|Median: $71.00
1.9× median
99203Top 5%

Office/outpatient visit, new patient, low-mod complexity

$217K

1,528 claims · 1.2%

Your Cost: $141.91/claim|Median: $57.85
2.5× median
99391Top 5%

Preventive medicine, established patient, infant (under 1)

$188K

1,070 claims · 1.0%

Your Cost: $175.48/claim|Median: $69.35
2.5× median
D2391Top 5%

Resin-based composite, one surface, posterior

$183K

1,656 claims · 1.0%

Your Cost: $110.23/claim|Median: $54.60
2.0× median
92012Top 1%

Ophthalmological exam, intermediate, established patient

$172K

1,123 claims · 0.9%

Your Cost: $153.10/claim|Median: $38.23
4.0× median
90832Top 5%

Psychotherapy, 30 minutes

$142K

987 claims · 0.8%

Your Cost: $144.17/claim|Median: $41.28
3.5× median
99383Top 5%

Preventive visit, new patient, late childhood (5-11 yr)

$117K

683 claims · 0.6%

Your Cost: $170.89/claim|Median: $81.92
2.1× median
D1351Normal range

Sealant, per tooth

$103K

12K claims · 0.6%

Your Cost: $8.34/claim|Median: $26.10
0.3× median
D9999Top 5%

Unspecified adjunctive procedure, by report

$97K

235 claims · 0.5%

Your Cost: $412.24/claim|Median: $37.60
11.0× median
99384Top 10%

Preventive visit, new patient, adolescent (12-17 yr)

$76K

449 claims · 0.4%

Your Cost: $169.21/claim|Median: $83.63
2.0× median
99382Top 5%

Preventive visit, new patient, early childhood (1-4 yr)

$70K

413 claims · 0.4%

Your Cost: $170.51/claim|Median: $79.89
2.1× median
D0274Normal range

Bitewings, four radiographic images

$63K

12K claims · 0.3%

Your Cost: $5.44/claim|Median: $22.54
0.2× median
D0272Normal range

Bitewings, two radiographic images

$48K

2,755 claims · 0.3%

Your Cost: $17.29/claim|Median: $15.81
1.1× median
99395Top 5%

Preventive medicine, established patient, age 18-39

$48K

281 claims · 0.3%

Your Cost: $169.27/claim|Median: $72.71
2.3× median
D0270Top 1%

$38K

798 claims · 0.2%

Your Cost: $48.19/claim|Median: $5.46
8.8× median
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