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Provider 1205804663

NPI: 1205804663Share
Active Billing Period:2018-01→2024-12(83 months)

Total Paid

$17.3M

$17,317,321

Total Claims

388K

Beneficiaries

313K

1.2 claims/patient

Avg Cost/Claim

$45

Monthly Spending Trend

Yearly Spending

2018
$1.5M
+5%
2019
$1.6M
-42%
2020
$899K
+212%
2021
$2.8M
+16%
2022
$3.3M
+18%
2023
$3.9M
-11%
2024
$3.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 26 distinct procedure codes. The top code (D2930 (Prefabricated stainless steel crown, primary tooth)) accounts for 23% of total spending.

D2930Top 25%

Prefabricated stainless steel crown, primary tooth

$4.0M

24K claims · 23.3%

Your Cost: $170.99/claim|Median: $120.85
1.4× median
D1120Normal range

Prophylaxis, adult

$2.6M

67K claims · 15.0%

Your Cost: $39.00/claim|Median: $33.86
1.2× median
D1206Normal range

Topical application of fluoride varnish

$1.7M

74K claims · 9.8%

Your Cost: $23.06/claim|Median: $18.12
1.3× median
D0120Top 25%

Periodic oral evaluation, established patient

$1.2M

42K claims · 7.1%

Your Cost: $29.29/claim|Median: $24.34
1.2× median
D1351Normal range

Sealant, per tooth

$1.2M

39K claims · 6.7%

Your Cost: $29.67/claim|Median: $26.10
1.1× median
D9230Top 10%

Inhalation of nitrous oxide/analgesia, anxiolysis

$1.1M

26K claims · 6.6%

Your Cost: $44.62/claim|Median: $26.24
1.7× median
D2392Top 25%

Resin-based composite, two surfaces, posterior

$1.0M

9,461 claims · 6.0%

Your Cost: $110.31/claim|Median: $71.00
1.6× median
D0160Top 10%

$1.0M

12K claims · 6.0%

Your Cost: $84.56/claim|Median: $34.71
2.4× median
D0272Top 10%

Bitewings, two radiographic images

$853K

33K claims · 4.9%

Your Cost: $26.11/claim|Median: $15.81
1.7× median
D7140Top 25%

Extraction, erupted tooth or exposed root

$580K

6,576 claims · 3.4%

Your Cost: $88.27/claim|Median: $57.39
1.5× median
D2391Top 25%

Resin-based composite, one surface, posterior

$541K

6,442 claims · 3.1%

Your Cost: $83.91/claim|Median: $54.60
1.5× median
D0150Top 25%

Comprehensive oral evaluation, new or established patient

$372K

7,669 claims · 2.1%

Your Cost: $48.49/claim|Median: $32.07
1.5× median
D0210Top 10%

Intraoral, complete series of radiographic images

$305K

3,886 claims · 1.8%

Your Cost: $78.47/claim|Median: $46.33
1.7× median
D0191Top 25%

$127K

7,802 claims · 0.7%

Your Cost: $16.30/claim|Median: $11.16
1.5× median
D0240Top 25%

$124K

5,801 claims · 0.7%

Your Cost: $21.40/claim|Median: $15.24
1.4× median
D9420Top 25%

$105K

581 claims · 0.6%

Your Cost: $181.44/claim|Median: $81.82
2.2× median
D1110Normal range

Prophylaxis, adult cleaning

$102K

1,964 claims · 0.6%

Your Cost: $51.83/claim|Median: $43.38
1.2× median
D1354Normal range

$95K

9,030 claims · 0.5%

Your Cost: $10.54/claim|Median: $12.52
0.8× median
D3220Top 25%

Therapeutic pulpotomy

$75K

723 claims · 0.4%

Your Cost: $103.45/claim|Median: $81.27
1.3× median
D0140Top 25%

Limited oral evaluation, problem focused

$34K

862 claims · 0.2%

Your Cost: $39.82/claim|Median: $27.07
1.5× median
D0274Top 10%

Bitewings, four radiographic images

$18K

472 claims · 0.1%

Your Cost: $37.13/claim|Median: $22.54
1.6× median
D0330Top 10%

Panoramic radiographic image

$15K

232 claims · 0.1%

Your Cost: $65.28/claim|Median: $37.36
1.7× median
D0220Top 10%

Intraoral periapical radiographic image, first film

$11K

685 claims · 0.1%

Your Cost: $15.62/claim|Median: $10.51
1.5× median
D9910Normal range

$5K

134 claims · 0.0%

Your Cost: $37.60/claim|Median: $45.26
0.8× median
D1310Normal range

Nutritional counseling for control of dental disease

$0

4,836 claims · 0.0%

Your Cost: $0.00/claim|Median: $40.52
D0603Normal range

$0

4,801 claims · 0.0%

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