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Provider 1194089771

NPI: 1194089771Share
Active Billing Period:2018-01→2024-12(56 months)

Total Paid

$8.9M

$8,896,005

Total Claims

313K

Beneficiaries

271K

1.2 claims/patient

Avg Cost/Claim

$28

Monthly Spending Trend

Yearly Spending

2018
$138
+1022%
2019
$2K
+21989%
2020
$343K
+594%
2021
$2.4M
-5%
2022
$2.3M
-2%
2023
$2.2M
-23%
2024
$1.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 23 distinct procedure codes. The top code (D2391 (Resin-based composite, one surface, posterior)) accounts for 19% of total spending.

D2391Top 25%

Resin-based composite, one surface, posterior

$1.7M

22K claims · 19.5%

Your Cost: $78.74/claim|Median: $54.60
1.4× median
D0120Top 25%

Periodic oral evaluation, established patient

$1.1M

38K claims · 12.2%

Your Cost: $28.56/claim|Median: $24.34
1.2× median
D0145Top 10%

Oral evaluation for patient under 3 years, counseling

$1.1M

7,629 claims · 12.1%

Your Cost: $141.06/claim|Median: $57.30
2.5× median
D1120Normal range

Prophylaxis, adult

$963K

27K claims · 10.8%

Your Cost: $36.28/claim|Median: $33.86
1.1× median
D1110Top 25%

Prophylaxis, adult cleaning

$723K

13K claims · 8.1%

Your Cost: $54.06/claim|Median: $43.38
1.2× median
D2392Top 25%

Resin-based composite, two surfaces, posterior

$590K

5,777 claims · 6.6%

Your Cost: $102.20/claim|Median: $71.00
1.4× median
D1208Normal range

Topical application of fluoride, excluding varnish

$588K

41K claims · 6.6%

Your Cost: $14.51/claim|Median: $14.36
1.0× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$462K

45K claims · 5.2%

Your Cost: $10.23/claim|Median: $7.33
1.4× median
D9230Normal range

Inhalation of nitrous oxide/analgesia, anxiolysis

$422K

16K claims · 4.7%

Your Cost: $26.83/claim|Median: $26.24
1.0× median
D0274Top 25%

Bitewings, four radiographic images

$392K

12K claims · 4.4%

Your Cost: $32.06/claim|Median: $22.54
1.4× median
D0210Top 25%

Intraoral, complete series of radiographic images

$305K

4,391 claims · 3.4%

Your Cost: $69.45/claim|Median: $46.33
1.5× median
D0272Top 25%

Bitewings, two radiographic images

$224K

10K claims · 2.5%

Your Cost: $21.53/claim|Median: $15.81
1.4× median
D0220Normal range

Intraoral periapical radiographic image, first film

$201K

18K claims · 2.3%

Your Cost: $10.98/claim|Median: $10.51
1.0× median
D2930Top 25%

Prefabricated stainless steel crown, primary tooth

$65K

440 claims · 0.7%

Your Cost: $146.78/claim|Median: $120.85
1.2× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$40K

1,194 claims · 0.5%

Your Cost: $33.82/claim|Median: $32.07
1.1× median
D0140Normal range

Limited oral evaluation, problem focused

$8K

419 claims · 0.1%

Your Cost: $18.39/claim|Median: $27.07
0.7× median
D0330Normal range

Panoramic radiographic image

$6K

1,341 claims · 0.1%

Your Cost: $4.27/claim|Median: $37.36
0.1× median
D2330Normal range

Resin-based composite filling, one surface, anterior

$4K

60 claims · 0.1%

Your Cost: $74.55/claim|Median: $66.63
1.1× median
D1351Normal range

Sealant, per tooth

$3K

121 claims · 0.0%

Your Cost: $27.07/claim|Median: $26.10
1.0× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$3K

33 claims · 0.0%

Your Cost: $98.29/claim|Median: $84.26
1.2× median
D7111Normal range

$138

12 claims · 0.0%

Your Cost: $11.47/claim|Median: $49.49
0.2× median
D0602Normal range

$0

25K claims · 0.0%

Your Cost: $0.00/claim|Median: $6.95
D0603Normal range

$0

24K claims · 0.0%

Your Cost: $0.00/claim|Median: $6.54
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