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Provider 1487128120

NPI: 1487128120Share
Active Billing Period:2019-03→2024-12(69 months)

Total Paid

$16.1M

$16,094,171

Total Claims

159K

Beneficiaries

76K

2.1 claims/patient

Avg Cost/Claim

$101

Monthly Spending Trend

Yearly Spending

2019
$1.2M
+27%
2020
$1.5M
+73%
2021
$2.6M
+53%
2022
$4.0M
-12%
2023
$3.5M
-7%
2024
$3.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 23 distinct procedure codes. The top code (D2930 (Prefabricated stainless steel crown, primary tooth)) accounts for 34% of total spending.

D2930Top 10%

Prefabricated stainless steel crown, primary tooth

$5.4M

27K claims · 33.5%

Your Cost: $197.30/claim|Median: $120.85
1.6× median
D2392Top 10%

Resin-based composite, two surfaces, posterior

$1.6M

13K claims · 10.1%

Your Cost: $125.57/claim|Median: $71.00
1.8× median
D3220Top 5%

Therapeutic pulpotomy

$1.5M

11K claims · 9.2%

Your Cost: $128.83/claim|Median: $81.27
1.6× median
D9223Normal range

Deep sedation/general anesthesia, each additional 15 min

$1.4M

15K claims · 8.8%

Your Cost: $92.03/claim|Median: $107.14
0.9× median
D2390Normal range

$1.2M

6,003 claims · 7.5%

Your Cost: $201.81/claim|Median: $170.27
1.2× median
D7140Top 25%

Extraction, erupted tooth or exposed root

$1.2M

13K claims · 7.3%

Your Cost: $91.34/claim|Median: $57.39
1.6× median
D2332Top 10%

$543K

4,128 claims · 3.4%

Your Cost: $131.49/claim|Median: $87.21
1.5× median
D1510Top 25%

$495K

2,457 claims · 3.1%

Your Cost: $201.34/claim|Median: $147.00
1.4× median
D9222Normal range

Deep sedation/general anesthesia, first 15 minutes

$461K

4,788 claims · 2.9%

Your Cost: $96.27/claim|Median: $90.28
1.1× median
D9420Top 25%

$359K

2,110 claims · 2.2%

Your Cost: $169.96/claim|Median: $81.82
2.1× median
D2391Top 10%

Resin-based composite, one surface, posterior

$357K

3,654 claims · 2.2%

Your Cost: $97.78/claim|Median: $54.60
1.8× median
D2330Top 10%

Resin-based composite filling, one surface, anterior

$276K

3,121 claims · 1.7%

Your Cost: $88.36/claim|Median: $66.63
1.3× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$209K

5,659 claims · 1.3%

Your Cost: $36.90/claim|Median: $32.07
1.2× median
D2393Top 25%

Resin-based composite, three surfaces, posterior

$199K

1,338 claims · 1.2%

Your Cost: $148.94/claim|Median: $84.26
1.8× median
D0230Top 25%

Intraoral, periapical radiographic image, first film

$198K

15K claims · 1.2%

Your Cost: $12.89/claim|Median: $7.33
1.8× median
D1351Normal range

Sealant, per tooth

$186K

6,236 claims · 1.2%

Your Cost: $29.84/claim|Median: $26.10
1.1× median
D1120Normal range

Prophylaxis, adult

$151K

5,712 claims · 0.9%

Your Cost: $26.35/claim|Median: $33.86
0.8× median
D1206Normal range

Topical application of fluoride varnish

$123K

5,946 claims · 0.8%

Your Cost: $20.68/claim|Median: $18.12
1.1× median
D0220Top 5%

Intraoral periapical radiographic image, first film

$95K

5,260 claims · 0.6%

Your Cost: $18.05/claim|Median: $10.51
1.7× median
D0240Normal range

$94K

6,297 claims · 0.6%

Your Cost: $14.97/claim|Median: $15.24
1.0× median
D2331Top 25%

Resin-based composite filling, two surfaces, anterior

$60K

550 claims · 0.4%

Your Cost: $108.24/claim|Median: $73.58
1.5× median
D0210Normal range

Intraoral, complete series of radiographic images

$2K

504 claims · 0.0%

Your Cost: $3.85/claim|Median: $46.33
0.1× median
D0272Normal range

Bitewings, two radiographic images

$234

12 claims · 0.0%

Your Cost: $19.52/claim|Median: $15.81
1.2× median
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