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Provider 1255639621

NPI: 1255639621Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$13.5M

$13,528,804

Total Claims

377K

Beneficiaries

345K

1.1 claims/patient

Avg Cost/Claim

$36

Monthly Spending Trend

Yearly Spending

2018
$1.6M
-5%
2019
$1.5M
+1%
2020
$1.5M
+28%
2021
$2.0M
+10%
2022
$2.2M
+11%
2023
$2.4M
-7%
2024
$2.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 26 distinct procedure codes. The top code (D1120 (Prophylaxis, adult)) accounts for 15% of total spending.

D1120Normal range

Prophylaxis, adult

$2.0M

63K claims · 14.6%

Your Cost: $31.61/claim|Median: $33.86
0.9× median
D2930Normal range

Prefabricated stainless steel crown, primary tooth

$1.9M

16K claims · 14.0%

Your Cost: $115.20/claim|Median: $120.85
1.0× median
D0120Normal range

Periodic oral evaluation, established patient

$1.5M

69K claims · 11.4%

Your Cost: $22.58/claim|Median: $24.34
0.9× median
D1208Normal range

Topical application of fluoride, excluding varnish

$1.3M

72K claims · 9.6%

Your Cost: $18.07/claim|Median: $14.36
1.3× median
D8080Top 5%

Comprehensive orthodontic treatment, adolescent dentition

$1.2M

334 claims · 9.0%

Your Cost: $3,626.31/claim|Median: $968.00
3.7× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$661K

9,469 claims · 4.9%

Your Cost: $69.82/claim|Median: $71.00
1.0× median
D7140Normal range

Extraction, erupted tooth or exposed root

$523K

8,176 claims · 3.9%

Your Cost: $63.97/claim|Median: $57.39
1.1× median
D9230Normal range

Inhalation of nitrous oxide/analgesia, anxiolysis

$476K

17K claims · 3.5%

Your Cost: $27.20/claim|Median: $26.24
1.0× median
D3220Normal range

Therapeutic pulpotomy

$446K

5,615 claims · 3.3%

Your Cost: $79.39/claim|Median: $81.27
1.0× median
D0272Normal range

Bitewings, two radiographic images

$446K

22K claims · 3.3%

Your Cost: $20.12/claim|Median: $15.81
1.3× median
D0274Normal range

Bitewings, four radiographic images

$436K

15K claims · 3.2%

Your Cost: $28.98/claim|Median: $22.54
1.3× median
D1110Normal range

Prophylaxis, adult cleaning

$436K

13K claims · 3.2%

Your Cost: $32.78/claim|Median: $43.38
0.8× median
D2391Normal range

Resin-based composite, one surface, posterior

$402K

7,669 claims · 3.0%

Your Cost: $52.48/claim|Median: $54.60
1.0× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$331K

9,561 claims · 2.4%

Your Cost: $34.62/claim|Median: $32.07
1.1× median
D2929Normal range

$289K

2,459 claims · 2.1%

Your Cost: $117.40/claim|Median: $154.83
0.8× median
D0230Top 10%

Intraoral, periapical radiographic image, first film

$254K

15K claims · 1.9%

Your Cost: $16.52/claim|Median: $7.33
2.3× median
D8660Normal range

$210K

2,081 claims · 1.6%

Your Cost: $101.15/claim|Median: $67.74
1.5× median
D0330Normal range

Panoramic radiographic image

$208K

4,790 claims · 1.5%

Your Cost: $43.40/claim|Median: $37.36
1.2× median
D0140Normal range

Limited oral evaluation, problem focused

$174K

5,913 claims · 1.3%

Your Cost: $29.39/claim|Median: $27.07
1.1× median
D0220Normal range

Intraoral periapical radiographic image, first film

$159K

14K claims · 1.2%

Your Cost: $11.31/claim|Median: $10.51
1.1× median
D9420Normal range

$97K

1,303 claims · 0.7%

Your Cost: $74.72/claim|Median: $81.82
0.9× median
D1351Normal range

Sealant, per tooth

$15K

680 claims · 0.1%

Your Cost: $22.60/claim|Median: $26.10
0.9× median
D1510Normal range

$14K

114 claims · 0.1%

Your Cost: $127.15/claim|Median: $147.00
0.9× median
D0240Normal range

$14K

1,362 claims · 0.1%

Your Cost: $10.20/claim|Median: $15.24
0.7× median
D0210Normal range

Intraoral, complete series of radiographic images

$5K

181 claims · 0.0%

Your Cost: $27.67/claim|Median: $46.33
0.6× median
D1354Top 25%

$4K

148 claims · 0.0%

Your Cost: $29.55/claim|Median: $12.52
2.4× median
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