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Provider 1316095904

NPI: 1316095904Share
Active Billing Period:2018-01→2024-07(77 months)

Total Paid

$8.0M

$7,981,074

Total Claims

166K

Beneficiaries

139K

1.2 claims/patient

Avg Cost/Claim

$48

Monthly Spending Trend

Yearly Spending

2018
$1.8M
-8%
2019
$1.6M
-42%
2020
$947K
+16%
2021
$1.1M
+3%
2022
$1.1M
-22%
2023
$877K
-43%
2024
$501K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (D2392 (Resin-based composite, two surfaces, posterior)) accounts for 14% of total spending.

D2392Top 1%

Resin-based composite, two surfaces, posterior

$1.1M

5,256 claims · 14.3%

Your Cost: $217.28/claim|Median: $71.00
3.1× median
D1120Top 5%

Prophylaxis, adult

$811K

16K claims · 10.2%

Your Cost: $52.27/claim|Median: $33.86
1.5× median
D0120Top 25%

Periodic oral evaluation, established patient

$755K

19K claims · 9.5%

Your Cost: $39.71/claim|Median: $24.34
1.6× median
D9230Top 5%

Inhalation of nitrous oxide/analgesia, anxiolysis

$516K

7,563 claims · 6.5%

Your Cost: $68.23/claim|Median: $26.24
2.6× median
D2930Top 5%

Prefabricated stainless steel crown, primary tooth

$500K

2,175 claims · 6.3%

Your Cost: $229.92/claim|Median: $120.85
1.9× median
D1110Top 25%

Prophylaxis, adult cleaning

$473K

6,714 claims · 5.9%

Your Cost: $70.50/claim|Median: $43.38
1.6× median
D7140Top 5%

Extraction, erupted tooth or exposed root

$471K

3,017 claims · 5.9%

Your Cost: $156.24/claim|Median: $57.39
2.7× median
D1351Top 25%

Sealant, per tooth

$457K

11K claims · 5.7%

Your Cost: $42.76/claim|Median: $26.10
1.6× median
D1206Top 10%

Topical application of fluoride varnish

$391K

13K claims · 4.9%

Your Cost: $31.27/claim|Median: $18.12
1.7× median
D2391Top 1%

Resin-based composite, one surface, posterior

$345K

1,969 claims · 4.3%

Your Cost: $175.20/claim|Median: $54.60
3.2× median
D0272Top 5%

Bitewings, two radiographic images

$316K

8,768 claims · 4.0%

Your Cost: $36.08/claim|Median: $15.81
2.3× median
D1208Top 1%

Topical application of fluoride, excluding varnish

$279K

8,908 claims · 3.5%

Your Cost: $31.37/claim|Median: $14.36
2.2× median
D2150Top 1%

Amalgam, two surfaces, primary or permanent

$232K

1,479 claims · 2.9%

Your Cost: $157.00/claim|Median: $66.00
2.4× median
D0274Top 5%

Bitewings, four radiographic images

$221K

4,412 claims · 2.8%

Your Cost: $50.14/claim|Median: $22.54
2.2× median
D9248Top 5%

$197K

767 claims · 2.5%

Your Cost: $256.27/claim|Median: $92.49
2.8× median
D0150Top 25%

Comprehensive oral evaluation, new or established patient

$179K

2,967 claims · 2.2%

Your Cost: $60.49/claim|Median: $32.07
1.9× median
D0330Top 5%

Panoramic radiographic image

$164K

2,170 claims · 2.1%

Your Cost: $75.60/claim|Median: $37.36
2.0× median
D2140Top 1%

Amalgam, one surface, primary or permanent

$117K

930 claims · 1.5%

Your Cost: $125.76/claim|Median: $52.77
2.4× median
D0220Top 5%

Intraoral periapical radiographic image, first film

$77K

3,300 claims · 1.0%

Your Cost: $23.37/claim|Median: $10.51
2.2× median
D0230Top 5%

Intraoral, periapical radiographic image, first film

$69K

3,554 claims · 0.9%

Your Cost: $19.54/claim|Median: $7.33
2.7× median
D0240Normal range

$57K

3,738 claims · 0.7%

Your Cost: $15.15/claim|Median: $15.24
1.0× median
D3220Top 5%

Therapeutic pulpotomy

$48K

290 claims · 0.6%

Your Cost: $163.92/claim|Median: $81.27
2.0× median
D2393Top 1%

Resin-based composite, three surfaces, posterior

$46K

179 claims · 0.6%

Your Cost: $258.64/claim|Median: $84.26
3.1× median
D2390Top 5%

$34K

87 claims · 0.4%

Your Cost: $396.32/claim|Median: $170.27
2.3× median
D0140Top 5%

Limited oral evaluation, problem focused

$29K

479 claims · 0.4%

Your Cost: $59.75/claim|Median: $27.07
2.2× median
D0160Top 5%

$15K

145 claims · 0.2%

Your Cost: $103.37/claim|Median: $34.71
3.0× median
D2330Top 5%

Resin-based composite filling, one surface, anterior

$14K

96 claims · 0.2%

Your Cost: $141.47/claim|Median: $66.63
2.1× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$13K

252 claims · 0.2%

Your Cost: $51.04/claim|Median: $57.30
0.9× median
D1550Top 1%

$5K

65 claims · 0.1%

Your Cost: $70.72/claim|Median: $28.26
2.5× median
D1510Top 5%

$4K

15 claims · 0.0%

Your Cost: $265.84/claim|Median: $147.00
1.8× median
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