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Provider 1417979170

NPI: 1417979170Share
Active Billing Period:2019-07→2024-12(64 months)

Total Paid

$11.0M

$11,046,429

Total Claims

128K

Beneficiaries

93K

1.4 claims/patient

Avg Cost/Claim

$86

Monthly Spending Trend

Yearly Spending

2019
$1.1M
+67%
2020
$1.9M
+66%
2021
$3.1M
-42%
2022
$1.8M
+15%
2023
$2.1M
-46%
2024
$1.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 29 distinct procedure codes. The top code (D0999 (Unspecified diagnostic procedure, by report)) accounts for 87% of total spending.

D0999Top 25%

Unspecified diagnostic procedure, by report

$9.6M

44K claims · 86.9%

Your Cost: $219.65/claim|Median: $101.33
2.2× median
D1206Normal range

Topical application of fluoride varnish

$226K

18K claims · 2.0%

Your Cost: $12.68/claim|Median: $18.12
0.7× median
D0120Normal range

Periodic oral evaluation, established patient

$128K

8,059 claims · 1.2%

Your Cost: $15.86/claim|Median: $24.34
0.7× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$127K

3,902 claims · 1.2%

Your Cost: $32.62/claim|Median: $32.07
1.0× median
D1120Normal range

Prophylaxis, adult

$126K

5,767 claims · 1.1%

Your Cost: $21.79/claim|Median: $33.86
0.6× median
D0330Normal range

Panoramic radiographic image

$89K

2,240 claims · 0.8%

Your Cost: $39.82/claim|Median: $37.36
1.1× median
D0220Normal range

Intraoral periapical radiographic image, first film

$86K

9,694 claims · 0.8%

Your Cost: $8.84/claim|Median: $10.51
0.8× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$82K

1,507 claims · 0.7%

Your Cost: $54.48/claim|Median: $71.00
0.8× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$71K

5,279 claims · 0.6%

Your Cost: $13.53/claim|Median: $57.30
0.2× median
D1110Normal range

Prophylaxis, adult cleaning

$58K

2,120 claims · 0.5%

Your Cost: $27.39/claim|Median: $43.38
0.6× median
D0140Normal range

Limited oral evaluation, problem focused

$57K

2,417 claims · 0.5%

Your Cost: $23.58/claim|Median: $27.07
0.9× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$53K

7,345 claims · 0.5%

Your Cost: $7.22/claim|Median: $7.33
1.0× median
D7140Normal range

Extraction, erupted tooth or exposed root

$52K

904 claims · 0.5%

Your Cost: $57.30/claim|Median: $57.39
1.0× median
D0274Normal range

Bitewings, four radiographic images

$51K

2,693 claims · 0.5%

Your Cost: $19.10/claim|Median: $22.54
0.8× median
D0272Normal range

Bitewings, two radiographic images

$48K

3,391 claims · 0.4%

Your Cost: $14.05/claim|Median: $15.81
0.9× median
D0190Normal range

$37K

6,593 claims · 0.3%

Your Cost: $5.62/claim|Median: $12.78
0.4× median
D2391Normal range

Resin-based composite, one surface, posterior

$34K

1,279 claims · 0.3%

Your Cost: $26.84/claim|Median: $54.60
0.5× median
D2150Top 10%

Amalgam, two surfaces, primary or permanent

$31K

342 claims · 0.3%

Your Cost: $89.60/claim|Median: $66.00
1.4× median
D4346Normal range

$26K

765 claims · 0.2%

Your Cost: $34.42/claim|Median: $61.42
0.6× median
D2140Top 10%

Amalgam, one surface, primary or permanent

$24K

341 claims · 0.2%

Your Cost: $70.20/claim|Median: $52.77
1.3× median
D0210Top 25%

Intraoral, complete series of radiographic images

$17K

267 claims · 0.2%

Your Cost: $64.17/claim|Median: $46.33
1.4× median
D1351Top 25%

Sealant, per tooth

$11K

336 claims · 0.1%

Your Cost: $33.80/claim|Median: $26.10
1.3× median
D9230Normal range

Inhalation of nitrous oxide/analgesia, anxiolysis

$6K

364 claims · 0.1%

Your Cost: $15.49/claim|Median: $26.24
0.6× median
D0240Normal range

$4K

241 claims · 0.0%

Your Cost: $17.33/claim|Median: $15.24
1.1× median
D1208Top 25%

Topical application of fluoride, excluding varnish

$2K

87 claims · 0.0%

Your Cost: $24.27/claim|Median: $14.36
1.7× median
D0180Normal range

$250

185 claims · 0.0%

Your Cost: $1.35/claim|Median: $35.21
0.0× median
D0270Normal range

$218

50 claims · 0.0%

Your Cost: $4.37/claim|Median: $5.46
0.8× median
D4342Normal range

$0

579 claims · 0.0%

Your Cost: $0.00/claim|Median: $42.00
D4910Normal range

$0

188 claims · 0.0%

Your Cost: $0.00/claim|Median: $75.56
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