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Provider 1205113560

NPI: 1205113560Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$16.8M

$16,776,123

Total Claims

175K

Beneficiaries

154K

1.1 claims/patient

Avg Cost/Claim

$96

Monthly Spending Trend

Yearly Spending

2018
$3.9M
-7%
2019
$3.6M
-19%
2020
$2.9M
-13%
2021
$2.5M
-25%
2022
$1.9M
-43%
2023
$1.1M
-29%
2024
$779K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (D0120 (Periodic oral evaluation, established patient)) accounts for 28% of total spending.

D0120Top 1%

Periodic oral evaluation, established patient

$4.7M

17K claims · 28.1%

Your Cost: $282.30/claim|Median: $24.34
11.6× median
D0140Top 1%

Limited oral evaluation, problem focused

$4.4M

17K claims · 26.1%

Your Cost: $257.69/claim|Median: $27.07
9.5× median
D0150Top 1%

Comprehensive oral evaluation, new or established patient

$2.6M

9,593 claims · 15.4%

Your Cost: $270.14/claim|Median: $32.07
8.4× median
D2392Top 5%

Resin-based composite, two surfaces, posterior

$1.3M

7,899 claims · 7.7%

Your Cost: $162.75/claim|Median: $71.00
2.3× median
D7140Top 5%

Extraction, erupted tooth or exposed root

$1.1M

8,245 claims · 6.5%

Your Cost: $132.78/claim|Median: $57.39
2.3× median
D2391Top 1%

Resin-based composite, one surface, posterior

$1.0M

7,041 claims · 6.2%

Your Cost: $147.33/claim|Median: $54.60
2.7× median
D5899Top 10%

$915K

3,250 claims · 5.5%

Your Cost: $281.41/claim|Median: $30.31
9.3× median
D2393Top 5%

Resin-based composite, three surfaces, posterior

$308K

1,850 claims · 1.8%

Your Cost: $166.66/claim|Median: $84.26
2.0× median
D2330Top 5%

Resin-based composite filling, one surface, anterior

$110K

888 claims · 0.7%

Your Cost: $123.77/claim|Median: $66.63
1.9× median
D2331Top 5%

Resin-based composite filling, two surfaces, anterior

$109K

855 claims · 0.7%

Your Cost: $127.83/claim|Median: $73.58
1.7× median
D2150Top 5%

Amalgam, two surfaces, primary or permanent

$92K

735 claims · 0.5%

Your Cost: $125.43/claim|Median: $66.00
1.9× median
D2335Top 10%

$50K

298 claims · 0.3%

Your Cost: $168.35/claim|Median: $105.06
1.6× median
D7210Top 5%

Extraction, erupted tooth, surgical approach

$31K

178 claims · 0.2%

Your Cost: $172.46/claim|Median: $109.42
1.6× median
D2332Top 10%

$16K

115 claims · 0.1%

Your Cost: $138.34/claim|Median: $87.21
1.6× median
D2394Top 5%

$13K

59 claims · 0.1%

Your Cost: $217.41/claim|Median: $102.14
2.1× median
D2140Top 5%

Amalgam, one surface, primary or permanent

$4K

36 claims · 0.0%

Your Cost: $101.36/claim|Median: $52.77
1.9× median
D1354Top 1%

$3K

30 claims · 0.0%

Your Cost: $101.78/claim|Median: $12.52
8.1× median
D2930Top 25%

Prefabricated stainless steel crown, primary tooth

$3K

18 claims · 0.0%

Your Cost: $165.47/claim|Median: $120.85
1.4× median
D2940Normal range

$2K

55 claims · 0.0%

Your Cost: $38.68/claim|Median: $34.80
1.1× median
D0330Normal range

Panoramic radiographic image

$2K

8,314 claims · 0.0%

Your Cost: $0.26/claim|Median: $37.36
0.0× median
D1110Normal range

Prophylaxis, adult cleaning

$2K

13K claims · 0.0%

Your Cost: $0.15/claim|Median: $43.38
0.0× median
D4355Normal range

$1K

1,617 claims · 0.0%

Your Cost: $0.87/claim|Median: $64.42
0.0× median
D0274Normal range

Bitewings, four radiographic images

$1K

13K claims · 0.0%

Your Cost: $0.10/claim|Median: $22.54
0.0× median
D1206Normal range

Topical application of fluoride varnish

$771

17K claims · 0.0%

Your Cost: $0.05/claim|Median: $18.12
0.0× median
D0220Normal range

Intraoral periapical radiographic image, first film

$499

14K claims · 0.0%

Your Cost: $0.04/claim|Median: $10.51
0.0× median
D1120Normal range

Prophylaxis, adult

$155

8,505 claims · 0.0%

Your Cost: $0.02/claim|Median: $33.86
0.0× median
D0272Normal range

Bitewings, two radiographic images

$143

4,503 claims · 0.0%

Your Cost: $0.03/claim|Median: $15.81
0.0× median
D1330Normal range

$129

2,082 claims · 0.0%

Your Cost: $0.06/claim|Median: $5.73
0.0× median
D0270Normal range

$69

3,087 claims · 0.0%

Your Cost: $0.02/claim|Median: $5.46
0.0× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$47

3,419 claims · 0.0%

Your Cost: $0.01/claim|Median: $7.33
0.0× median
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