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Provider 1508961749

NPI: 1508961749Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$10.8M

$10,798,437

Total Claims

186K

Beneficiaries

167K

1.1 claims/patient

Avg Cost/Claim

$58

Monthly Spending Trend

Yearly Spending

2018
$2.2M
-8%
2019
$2.0M
-42%
2020
$1.1M
+19%
2021
$1.4M
-4%
2022
$1.3M
+22%
2023
$1.6M
-20%
2024
$1.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (D1110 (Prophylaxis, adult cleaning)) accounts for 13% of total spending.

D1110Top 25%

Prophylaxis, adult cleaning

$1.4M

21K claims · 12.9%

Your Cost: $64.66/claim|Median: $43.38
1.5× median
D2392Top 10%

Resin-based composite, two surfaces, posterior

$1.2M

9,724 claims · 10.9%

Your Cost: $120.88/claim|Median: $71.00
1.7× median
D0120Top 25%

Periodic oral evaluation, established patient

$1.1M

27K claims · 10.2%

Your Cost: $40.26/claim|Median: $24.34
1.7× median
D7140Top 25%

Extraction, erupted tooth or exposed root

$869K

9,868 claims · 8.1%

Your Cost: $88.10/claim|Median: $57.39
1.5× median
D2391Top 10%

Resin-based composite, one surface, posterior

$785K

8,121 claims · 7.3%

Your Cost: $96.63/claim|Median: $54.60
1.8× median
D1120Normal range

Prophylaxis, adult

$638K

16K claims · 5.9%

Your Cost: $39.87/claim|Median: $33.86
1.2× median
D1206Top 25%

Topical application of fluoride varnish

$491K

20K claims · 4.5%

Your Cost: $24.79/claim|Median: $18.12
1.4× median
D2393Top 25%

Resin-based composite, three surfaces, posterior

$455K

3,238 claims · 4.2%

Your Cost: $140.50/claim|Median: $84.26
1.7× median
D0140Top 5%

Limited oral evaluation, problem focused

$450K

5,633 claims · 4.2%

Your Cost: $79.86/claim|Median: $27.07
3.0× median
D0150Top 25%

Comprehensive oral evaluation, new or established patient

$449K

7,126 claims · 4.2%

Your Cost: $63.06/claim|Median: $32.07
2.0× median
D0210Normal range

Intraoral, complete series of radiographic images

$348K

6,890 claims · 3.2%

Your Cost: $50.47/claim|Median: $46.33
1.1× median
D2331Top 25%

Resin-based composite filling, two surfaces, anterior

$326K

3,138 claims · 3.0%

Your Cost: $103.84/claim|Median: $73.58
1.4× median
D5110Top 10%

$275K

338 claims · 2.5%

Your Cost: $812.38/claim|Median: $472.15
1.7× median
D0274Normal range

Bitewings, four radiographic images

$244K

9,991 claims · 2.3%

Your Cost: $24.38/claim|Median: $22.54
1.1× median
D1351Normal range

Sealant, per tooth

$219K

7,974 claims · 2.0%

Your Cost: $27.51/claim|Median: $26.10
1.1× median
D2330Top 10%

Resin-based composite filling, one surface, anterior

$201K

2,268 claims · 1.9%

Your Cost: $88.72/claim|Median: $66.63
1.3× median
D2335Top 25%

$183K

1,319 claims · 1.7%

Your Cost: $138.96/claim|Median: $105.06
1.3× median
D2332Top 25%

$165K

1,377 claims · 1.5%

Your Cost: $119.69/claim|Median: $87.21
1.4× median
D2740Normal range

Crown, porcelain/ceramic substrate

$155K

259 claims · 1.4%

Your Cost: $597.74/claim|Median: $509.58
1.2× median
D2930Top 25%

Prefabricated stainless steel crown, primary tooth

$151K

839 claims · 1.4%

Your Cost: $179.56/claim|Median: $120.85
1.5× median
D0272Top 25%

Bitewings, two radiographic images

$100K

4,575 claims · 0.9%

Your Cost: $21.81/claim|Median: $15.81
1.4× median
D2150Top 5%

Amalgam, two surfaces, primary or permanent

$93K

931 claims · 0.9%

Your Cost: $100.28/claim|Median: $66.00
1.5× median
D0220Normal range

Intraoral periapical radiographic image, first film

$79K

8,155 claims · 0.7%

Your Cost: $9.68/claim|Median: $10.51
0.9× median
D0240Top 25%

$72K

3,537 claims · 0.7%

Your Cost: $20.40/claim|Median: $15.24
1.3× median
D2394Top 25%

$60K

385 claims · 0.6%

Your Cost: $155.79/claim|Median: $102.14
1.5× median
D5120Normal range

$60K

156 claims · 0.6%

Your Cost: $383.91/claim|Median: $468.71
0.8× median
D2140Top 5%

Amalgam, one surface, primary or permanent

$55K

666 claims · 0.5%

Your Cost: $82.76/claim|Median: $52.77
1.6× median
D4355Top 10%

$48K

412 claims · 0.4%

Your Cost: $116.76/claim|Median: $64.42
1.8× median
D2160Top 5%

Amalgam filling, three surfaces

$38K

330 claims · 0.4%

Your Cost: $116.65/claim|Median: $78.55
1.5× median
D7210Top 25%

Extraction, erupted tooth, surgical approach

$27K

210 claims · 0.2%

Your Cost: $126.37/claim|Median: $109.42
1.2× median
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