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Provider 1558765339

NPI: 1558765339Share
Active Billing Period:2018-01→2024-12(83 months)

Total Paid

$9.3M

$9,326,373

Total Claims

230K

Beneficiaries

200K

1.1 claims/patient

Avg Cost/Claim

$41

Monthly Spending Trend

Yearly Spending

2018
$1.3M
+15%
2019
$1.5M
-25%
2020
$1.1M
+44%
2021
$1.6M
+14%
2022
$1.8M
-13%
2023
$1.5M
-58%
2024
$646K

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 13% of total spending.

D2930Normal range

Prefabricated stainless steel crown, primary tooth

$1.2M

9,331 claims · 12.6%

Your Cost: $126.28/claim|Median: $120.85
1.0× median
D2150Top 5%

Amalgam, two surfaces, primary or permanent

$1.0M

8,897 claims · 11.1%

Your Cost: $116.31/claim|Median: $66.00
1.8× median
D1206Normal range

Topical application of fluoride varnish

$754K

41K claims · 8.1%

Your Cost: $18.22/claim|Median: $18.12
1.0× median
D1120Normal range

Prophylaxis, adult

$734K

22K claims · 7.9%

Your Cost: $32.72/claim|Median: $33.86
1.0× median
D0120Normal range

Periodic oral evaluation, established patient

$711K

30K claims · 7.6%

Your Cost: $23.48/claim|Median: $24.34
1.0× median
D1110Normal range

Prophylaxis, adult cleaning

$632K

14K claims · 6.8%

Your Cost: $44.12/claim|Median: $43.38
1.0× median
D1351Top 25%

Sealant, per tooth

$440K

13K claims · 4.7%

Your Cost: $34.80/claim|Median: $26.10
1.3× median
D9230Normal range

Inhalation of nitrous oxide/analgesia, anxiolysis

$429K

14K claims · 4.6%

Your Cost: $31.23/claim|Median: $26.24
1.2× median
D2140Top 5%

Amalgam, one surface, primary or permanent

$393K

4,180 claims · 4.2%

Your Cost: $94.07/claim|Median: $52.77
1.8× median
D0272Top 25%

Bitewings, two radiographic images

$308K

15K claims · 3.3%

Your Cost: $20.96/claim|Median: $15.81
1.3× median
D2391Top 5%

Resin-based composite, one surface, posterior

$275K

2,618 claims · 3.0%

Your Cost: $105.11/claim|Median: $54.60
1.9× median
D0274Top 25%

Bitewings, four radiographic images

$273K

9,179 claims · 2.9%

Your Cost: $29.79/claim|Median: $22.54
1.3× median
D0350Top 5%

$261K

6,718 claims · 2.8%

Your Cost: $38.82/claim|Median: $9.73
4.0× median
D7240Top 25%

Extraction, impacted tooth, complete bony

$235K

840 claims · 2.5%

Your Cost: $280.33/claim|Median: $231.00
1.2× median
D3220Normal range

Therapeutic pulpotomy

$199K

2,327 claims · 2.1%

Your Cost: $85.72/claim|Median: $81.27
1.1× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$165K

4,174 claims · 1.8%

Your Cost: $39.63/claim|Median: $32.07
1.2× median
D0330Top 25%

Panoramic radiographic image

$153K

2,872 claims · 1.6%

Your Cost: $53.20/claim|Median: $37.36
1.4× median
D2392Top 5%

Resin-based composite, two surfaces, posterior

$139K

1,037 claims · 1.5%

Your Cost: $133.76/claim|Median: $71.00
1.9× median
D7140Top 10%

Extraction, erupted tooth or exposed root

$134K

1,341 claims · 1.4%

Your Cost: $99.93/claim|Median: $57.39
1.7× median
D0220Top 25%

Intraoral periapical radiographic image, first film

$130K

10K claims · 1.4%

Your Cost: $12.55/claim|Median: $10.51
1.2× median
D0230Top 5%

Intraoral, periapical radiographic image, first film

$123K

5,382 claims · 1.3%

Your Cost: $22.78/claim|Median: $7.33
3.1× median
D2934Normal range

$122K

718 claims · 1.3%

Your Cost: $170.16/claim|Median: $143.67
1.2× median
D2160Top 5%

Amalgam filling, three surfaces

$112K

778 claims · 1.2%

Your Cost: $143.62/claim|Median: $78.55
1.8× median
D9248Top 10%

$98K

690 claims · 1.0%

Your Cost: $141.47/claim|Median: $92.49
1.5× median
D1353Top 10%

$88K

2,514 claims · 0.9%

Your Cost: $34.81/claim|Median: $14.03
2.5× median
D7111Normal range

$72K

1,368 claims · 0.8%

Your Cost: $52.54/claim|Median: $49.49
1.1× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$56K

1,770 claims · 0.6%

Your Cost: $31.59/claim|Median: $57.30
0.6× median
D0140Normal range

Limited oral evaluation, problem focused

$45K

1,273 claims · 0.5%

Your Cost: $35.03/claim|Median: $27.07
1.3× median
D0210Normal range

Intraoral, complete series of radiographic images

$18K

1,318 claims · 0.2%

Your Cost: $13.38/claim|Median: $46.33
0.3× median
D1352Normal range

$3K

90 claims · 0.0%

Your Cost: $33.36/claim|Median: $33.43
1.0× median
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