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Provider 1205076668

NPI: 1205076668Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$17.3M

$17,279,547

Total Claims

441K

Beneficiaries

371K

1.2 claims/patient

Avg Cost/Claim

$39

Monthly Spending Trend

Yearly Spending

2018
$2.5M
+5%
2019
$2.6M
-13%
2020
$2.3M
+16%
2021
$2.7M
-7%
2022
$2.5M
-3%
2023
$2.4M
-1%
2024
$2.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 24 distinct procedure codes. The top code (D2392 (Resin-based composite, two surfaces, posterior)) accounts for 24% of total spending.

D2392Top 25%

Resin-based composite, two surfaces, posterior

$4.2M

40K claims · 24.1%

Your Cost: $103.37/claim|Median: $71.00
1.5× median
D0120Normal range

Periodic oral evaluation, established patient

$1.9M

73K claims · 10.8%

Your Cost: $25.34/claim|Median: $24.34
1.0× median
D1120Normal range

Prophylaxis, adult

$1.4M

52K claims · 8.0%

Your Cost: $26.73/claim|Median: $33.86
0.8× median
D9230Top 25%

Inhalation of nitrous oxide/analgesia, anxiolysis

$1.3M

31K claims · 7.6%

Your Cost: $42.84/claim|Median: $26.24
1.6× median
D1208Normal range

Topical application of fluoride, excluding varnish

$1.2M

73K claims · 6.8%

Your Cost: $16.15/claim|Median: $14.36
1.1× median
D2393Top 25%

Resin-based composite, three surfaces, posterior

$1.0M

8,152 claims · 5.8%

Your Cost: $122.90/claim|Median: $84.26
1.5× median
D1110Normal range

Prophylaxis, adult cleaning

$952K

26K claims · 5.5%

Your Cost: $37.06/claim|Median: $43.38
0.9× median
D7140Normal range

Extraction, erupted tooth or exposed root

$936K

15K claims · 5.4%

Your Cost: $62.22/claim|Median: $57.39
1.1× median
D2391Top 25%

Resin-based composite, one surface, posterior

$917K

12K claims · 5.3%

Your Cost: $78.07/claim|Median: $54.60
1.4× median
D1351Normal range

Sealant, per tooth

$892K

32K claims · 5.2%

Your Cost: $27.76/claim|Median: $26.10
1.1× median
D2930Normal range

Prefabricated stainless steel crown, primary tooth

$607K

4,371 claims · 3.5%

Your Cost: $138.96/claim|Median: $120.85
1.1× median
D0274Top 25%

Bitewings, four radiographic images

$430K

14K claims · 2.5%

Your Cost: $31.04/claim|Median: $22.54
1.4× median
D0272Normal range

Bitewings, two radiographic images

$405K

22K claims · 2.3%

Your Cost: $18.02/claim|Median: $15.81
1.1× median
D0330Top 25%

Panoramic radiographic image

$367K

6,395 claims · 2.1%

Your Cost: $57.32/claim|Median: $37.36
1.5× median
D3220Normal range

Therapeutic pulpotomy

$195K

2,489 claims · 1.1%

Your Cost: $78.44/claim|Median: $81.27
1.0× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$182K

4,268 claims · 1.1%

Your Cost: $42.75/claim|Median: $32.07
1.3× median
D0140Top 25%

Limited oral evaluation, problem focused

$146K

4,067 claims · 0.8%

Your Cost: $35.89/claim|Median: $27.07
1.3× median
D0220Top 25%

Intraoral periapical radiographic image, first film

$140K

9,672 claims · 0.8%

Your Cost: $14.43/claim|Median: $10.51
1.4× median
D0240Normal range

$105K

6,793 claims · 0.6%

Your Cost: $15.43/claim|Median: $15.24
1.0× median
D1206Normal range

Topical application of fluoride varnish

$58K

3,664 claims · 0.3%

Your Cost: $15.73/claim|Median: $18.12
0.9× median
D2330Normal range

Resin-based composite filling, one surface, anterior

$17K

253 claims · 0.1%

Your Cost: $65.59/claim|Median: $66.63
1.0× median
D1510Normal range

$15K

79 claims · 0.1%

Your Cost: $187.96/claim|Median: $147.00
1.3× median
D2332Normal range

$9K

97 claims · 0.1%

Your Cost: $97.71/claim|Median: $87.21
1.1× median
D0230Top 25%

Intraoral, periapical radiographic image, first film

$6K

534 claims · 0.0%

Your Cost: $10.65/claim|Median: $7.33
1.5× median
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