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

⚖️ Compare🖨️ Print Report

Provider 1265813042

NPI: 1265813042Share
Active Billing Period:2018-01→2024-09(81 months)

Total Paid

$11.0M

$11,015,963

Total Claims

310K

Beneficiaries

226K

1.4 claims/patient

Avg Cost/Claim

$36

Monthly Spending Trend

Yearly Spending

2018
$1.9M
-1%
2019
$1.9M
-6%
2020
$1.8M
+6%
2021
$1.9M
+6%
2022
$2.0M
-33%
2023
$1.4M
-100%
2024
$0

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (D2930 (Prefabricated stainless steel crown, primary tooth)) accounts for 18% of total spending.

D2930Normal range

Prefabricated stainless steel crown, primary tooth

$2.0M

17K claims · 17.9%

Your Cost: $116.23/claim|Median: $120.85
1.0× median
D9223Normal range

Deep sedation/general anesthesia, each additional 15 min

$1.7M

30K claims · 15.2%

Your Cost: $55.09/claim|Median: $107.14
0.5× median
D2391Normal range

Resin-based composite, one surface, posterior

$785K

13K claims · 7.1%

Your Cost: $61.11/claim|Median: $54.60
1.1× median
D1120Normal range

Prophylaxis, adult

$759K

28K claims · 6.9%

Your Cost: $27.34/claim|Median: $33.86
0.8× median
D1206Normal range

Topical application of fluoride varnish

$643K

37K claims · 5.8%

Your Cost: $17.27/claim|Median: $18.12
1.0× median
D7140Normal range

Extraction, erupted tooth or exposed root

$631K

11K claims · 5.7%

Your Cost: $58.99/claim|Median: $57.39
1.0× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$605K

8,195 claims · 5.5%

Your Cost: $73.84/claim|Median: $71.00
1.0× median
D0120Normal range

Periodic oral evaluation, established patient

$515K

31K claims · 4.7%

Your Cost: $16.51/claim|Median: $24.34
0.7× median
D1110Normal range

Prophylaxis, adult cleaning

$420K

10K claims · 3.8%

Your Cost: $40.90/claim|Median: $43.38
0.9× median
D1351Normal range

Sealant, per tooth

$395K

15K claims · 3.6%

Your Cost: $27.02/claim|Median: $26.10
1.0× median
D9310Top 25%

$382K

5,524 claims · 3.5%

Your Cost: $69.08/claim|Median: $46.20
1.5× median
D9230Normal range

Inhalation of nitrous oxide/analgesia, anxiolysis

$330K

12K claims · 3.0%

Your Cost: $28.39/claim|Median: $26.24
1.1× median
D9222Normal range

Deep sedation/general anesthesia, first 15 minutes

$283K

5,304 claims · 2.6%

Your Cost: $53.45/claim|Median: $90.28
0.6× median
D0272Normal range

Bitewings, two radiographic images

$237K

14K claims · 2.1%

Your Cost: $16.74/claim|Median: $15.81
1.1× median
D9612Normal range

$185K

5,432 claims · 1.7%

Your Cost: $33.99/claim|Median: $35.08
1.0× median
D3120Normal range

$178K

11K claims · 1.6%

Your Cost: $16.06/claim|Median: $24.98
0.6× median
D0274Normal range

Bitewings, four radiographic images

$177K

7,282 claims · 1.6%

Your Cost: $24.32/claim|Median: $22.54
1.1× median
D0210Normal range

Intraoral, complete series of radiographic images

$170K

7,468 claims · 1.5%

Your Cost: $22.78/claim|Median: $46.33
0.5× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$133K

5,139 claims · 1.2%

Your Cost: $25.97/claim|Median: $32.07
0.8× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$118K

13K claims · 1.1%

Your Cost: $9.45/claim|Median: $7.33
1.3× median
D9630Normal range

$114K

6,609 claims · 1.0%

Your Cost: $17.32/claim|Median: $17.78
1.0× median
D0220Normal range

Intraoral periapical radiographic image, first film

$81K

8,778 claims · 0.7%

Your Cost: $9.27/claim|Median: $10.51
0.9× median
D0240Normal range

$54K

5,462 claims · 0.5%

Your Cost: $9.90/claim|Median: $15.24
0.6× median
D7240Normal range

Extraction, impacted tooth, complete bony

$43K

177 claims · 0.4%

Your Cost: $244.72/claim|Median: $231.00
1.1× median
D0140Normal range

Limited oral evaluation, problem focused

$33K

1,681 claims · 0.3%

Your Cost: $19.82/claim|Median: $27.07
0.7× median
D3220Normal range

Therapeutic pulpotomy

$30K

350 claims · 0.3%

Your Cost: $86.64/claim|Median: $81.27
1.1× median
D0330Normal range

Panoramic radiographic image

$14K

322 claims · 0.1%

Your Cost: $43.66/claim|Median: $37.36
1.2× median
D2330Top 10%

Resin-based composite filling, one surface, anterior

$14K

157 claims · 0.1%

Your Cost: $88.19/claim|Median: $66.63
1.3× median
D2332Normal range

$13K

123 claims · 0.1%

Your Cost: $103.19/claim|Median: $87.21
1.2× median
D2934Top 25%

$11K

56 claims · 0.1%

Your Cost: $189.76/claim|Median: $143.67
1.3× median
← All providersHow we detect fraud →