Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

⚖️ Compare🖨️ Print Report

KOOL SMILES, PSC

Dentist, General Practice·LEXINGTON, KY·NPI: 1205026788Share

Compared to Dentist, General Practice Peers

Total spending distribution among 10 providers in this specialty

P25MedianP75P90

This provider's total spending of $30.7M is at the 75th percentile among 10 Dentist, General Practice providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$30.7M

$30,674,321

Total Claims

906K

Beneficiaries

767K

1.2 claims/patient

Avg Cost/Claim

$34

Monthly Spending Trend

Yearly Spending

2018
$5.2M
+7%
2019
$5.5M
-41%
2020
$3.2M
+26%
2021
$4.1M
-16%
2022
$3.4M
+44%
2023
$4.9M
-11%
2024
$4.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (D1120 (Prophylaxis, adult)) accounts for 15% of total spending.

D1120Top 10%

Prophylaxis, adult

$4.6M

97K claims · 15.1%

Your Cost: $47.71/claim|Median: $33.86
1.4× median
D8080Top 25%

Comprehensive orthodontic treatment, adolescent dentition

$3.3M

1,761 claims · 10.8%

Your Cost: $1,873.59/claim|Median: $968.00
1.9× median
D0120Normal range

Periodic oral evaluation, established patient

$1.7M

82K claims · 5.5%

Your Cost: $20.45/claim|Median: $24.34
0.8× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$1.6M

25K claims · 5.3%

Your Cost: $65.11/claim|Median: $71.00
0.9× median
D2930Normal range

Prefabricated stainless steel crown, primary tooth

$1.6M

15K claims · 5.2%

Your Cost: $108.49/claim|Median: $120.85
0.9× median
D1208Normal range

Topical application of fluoride, excluding varnish

$1.5M

106K claims · 5.0%

Your Cost: $14.57/claim|Median: $14.36
1.0× median
D0330Normal range

Panoramic radiographic image

$1.4M

37K claims · 4.7%

Your Cost: $39.25/claim|Median: $37.36
1.1× median
D1110Normal range

Prophylaxis, adult cleaning

$1.4M

29K claims · 4.7%

Your Cost: $48.96/claim|Median: $43.38
1.1× median
D1351Normal range

Sealant, per tooth

$1.4M

73K claims · 4.5%

Your Cost: $18.67/claim|Median: $26.10
0.7× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$1.3M

48K claims · 4.2%

Your Cost: $26.69/claim|Median: $32.07
0.8× median
D8670Top 5%

Periodic orthodontic treatment visit

$1.2M

1,637 claims · 4.0%

Your Cost: $741.81/claim|Median: $185.01
4.0× median
D0272Normal range

Bitewings, two radiographic images

$1.2M

74K claims · 3.8%

Your Cost: $15.77/claim|Median: $15.81
1.0× median
D2391Normal range

Resin-based composite, one surface, posterior

$985K

20K claims · 3.2%

Your Cost: $48.57/claim|Median: $54.60
0.9× median
D7240Normal range

Extraction, impacted tooth, complete bony

$966K

6,184 claims · 3.2%

Your Cost: $156.27/claim|Median: $231.00
0.7× median
D9230Normal range

Inhalation of nitrous oxide/analgesia, anxiolysis

$889K

29K claims · 2.9%

Your Cost: $31.00/claim|Median: $26.24
1.2× median
D0274Normal range

Bitewings, four radiographic images

$771K

33K claims · 2.5%

Your Cost: $23.02/claim|Median: $22.54
1.0× median
D7140Normal range

Extraction, erupted tooth or exposed root

$698K

15K claims · 2.3%

Your Cost: $48.02/claim|Median: $57.39
0.8× median
D0220Normal range

Intraoral periapical radiographic image, first film

$634K

68K claims · 2.1%

Your Cost: $9.31/claim|Median: $10.51
0.9× median
D2140Normal range

Amalgam, one surface, primary or permanent

$524K

12K claims · 1.7%

Your Cost: $43.75/claim|Median: $52.77
0.8× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$426K

5,772 claims · 1.4%

Your Cost: $73.86/claim|Median: $84.26
0.9× median
D2150Normal range

Amalgam, two surfaces, primary or permanent

$418K

7,273 claims · 1.4%

Your Cost: $57.46/claim|Median: $66.00
0.9× median
D0140Normal range

Limited oral evaluation, problem focused

$388K

12K claims · 1.3%

Your Cost: $33.11/claim|Median: $27.07
1.2× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$374K

57K claims · 1.2%

Your Cost: $6.58/claim|Median: $7.33
0.9× median
D7210Normal range

Extraction, erupted tooth, surgical approach

$311K

2,977 claims · 1.0%

Your Cost: $104.56/claim|Median: $109.42
1.0× median
D1206Normal range

Topical application of fluoride varnish

$264K

16K claims · 0.9%

Your Cost: $16.68/claim|Median: $18.12
0.9× median
D8660Normal range

$144K

2,044 claims · 0.5%

Your Cost: $70.45/claim|Median: $67.74
1.0× median
D2332Normal range

$92K

1,280 claims · 0.3%

Your Cost: $71.82/claim|Median: $87.21
0.8× median
D7230Normal range

Extraction, impacted tooth, partial bony

$75K

595 claims · 0.2%

Your Cost: $126.33/claim|Median: $187.09
0.7× median
D7111Normal range

$75K

1,535 claims · 0.2%

Your Cost: $48.80/claim|Median: $49.49
1.0× median
D3220Normal range

Therapeutic pulpotomy

$74K

1,189 claims · 0.2%

Your Cost: $61.85/claim|Median: $81.27
0.8× median
D2330Normal range

Resin-based composite filling, one surface, anterior

$51K

1,007 claims · 0.2%

Your Cost: $50.19/claim|Median: $66.63
0.8× median
D2335Normal range

$40K

477 claims · 0.1%

Your Cost: $84.10/claim|Median: $105.06
0.8× median
D1352Normal range

$36K

998 claims · 0.1%

Your Cost: $36.15/claim|Median: $33.43
1.1× median
D8999Normal range

$35K

330 claims · 0.1%

Your Cost: $106.71/claim|Median: $47.03
2.3× median
D4341Normal range

Periodontal scaling, per quadrant

$25K

425 claims · 0.1%

Your Cost: $57.97/claim|Median: $70.00
0.8× median
D0210Normal range

Intraoral, complete series of radiographic images

$16K

457 claims · 0.1%

Your Cost: $34.48/claim|Median: $46.33
0.7× median
D0270Normal range

$15K

2,286 claims · 0.0%

Your Cost: $6.45/claim|Median: $5.46
1.2× median
D0180Top 10%

$13K

223 claims · 0.0%

Your Cost: $57.40/claim|Median: $35.21
1.6× median
D0160Top 25%

$12K

174 claims · 0.0%

Your Cost: $70.09/claim|Median: $34.71
2.0× median
D1353Normal range

$8K

514 claims · 0.0%

Your Cost: $15.78/claim|Median: $14.03
1.1× median
D2394Normal range

$7K

93 claims · 0.0%

Your Cost: $76.96/claim|Median: $102.14
0.8× median
D2331Normal range

Resin-based composite filling, two surfaces, anterior

$6K

92 claims · 0.0%

Your Cost: $65.03/claim|Median: $73.58
0.9× median
D2160Normal range

Amalgam filling, three surfaces

$4K

71 claims · 0.0%

Your Cost: $62.41/claim|Median: $78.55
0.8× median
D3120Top 5%

$3K

68 claims · 0.0%

Your Cost: $49.56/claim|Median: $24.98
2.0× median
D4355Normal range

$3K

87 claims · 0.0%

Your Cost: $35.04/claim|Median: $64.42
0.5× median
D0340Normal range

$220

64 claims · 0.0%

Your Cost: $3.44/claim|Median: $49.44
0.1× median
D9110Normal range

$0

12 claims · 0.0%

Your Cost: $0.00/claim|Median: $38.08
D7922Normal range

$0

293 claims · 0.0%

Your Cost: $0.00/claim|Median: $25.74
D0240Normal range

$0

107 claims · 0.0%

Your Cost: $0.00/claim|Median: $15.24
D1999Normal range

$0

17K claims · 0.0%

Your Cost: $0.00/claim|Median: $11.95

Other Top Providers in Kentucky

View all →

University of Kentucky

General Acute Care Hospital

$716.4M

Norton Hospitals INC

General Acute Care Hospital

$419.6M

Seven Counties Services Inc.

Clinic/Center Developmental Disabilities

$375.8M

Cumberland River Behavioral Health INC

Community/Behavioral Health

$349.2M

Addiction Recovery Care LLC

Community Based Residential Treatment Facility, Me

$309.0M

Similar Providers

Other top providers in Dentist, General Practice

Rochester General Hospital

Rochester, NY

$227.0M

← All providersAll providers in Kentucky →How we detect fraud →