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Provider 1609018548

NPI: 1609018548Share
Active Billing Period:2021-10→2024-12(39 months)

Total Paid

$12.8M

$12,836,064

Total Claims

305K

Beneficiaries

252K

1.2 claims/patient

Avg Cost/Claim

$42

Monthly Spending Trend

Yearly Spending

2021
$652K
+476%
2022
$3.8M
+22%
2023
$4.6M
-16%
2024
$3.8M

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 14% of total spending.

D2930Normal range

Prefabricated stainless steel crown, primary tooth

$1.8M

15K claims · 14.0%

Your Cost: $119.20/claim|Median: $120.85
1.0× median
D2392Top 25%

Resin-based composite, two surfaces, posterior

$1.5M

14K claims · 11.8%

Your Cost: $111.43/claim|Median: $71.00
1.6× median
D9248Top 25%

$1.1M

8,472 claims · 8.8%

Your Cost: $132.97/claim|Median: $92.49
1.4× median
D1120Normal range

Prophylaxis, adult

$957K

32K claims · 7.5%

Your Cost: $30.25/claim|Median: $33.86
0.9× median
D0120Normal range

Periodic oral evaluation, established patient

$755K

36K claims · 5.9%

Your Cost: $21.14/claim|Median: $24.34
0.9× median
D1206Normal range

Topical application of fluoride varnish

$744K

43K claims · 5.8%

Your Cost: $17.25/claim|Median: $18.12
1.0× median
D1351Normal range

Sealant, per tooth

$553K

23K claims · 4.3%

Your Cost: $24.10/claim|Median: $26.10
0.9× median
D1110Normal range

Prophylaxis, adult cleaning

$547K

12K claims · 4.3%

Your Cost: $45.16/claim|Median: $43.38
1.0× median
D2393Top 10%

Resin-based composite, three surfaces, posterior

$479K

3,145 claims · 3.7%

Your Cost: $152.28/claim|Median: $84.26
1.8× median
D3220Normal range

Therapeutic pulpotomy

$469K

5,181 claims · 3.7%

Your Cost: $90.47/claim|Median: $81.27
1.1× median
D2934Normal range

$393K

2,611 claims · 3.1%

Your Cost: $150.57/claim|Median: $143.67
1.0× median
D7140Normal range

Extraction, erupted tooth or exposed root

$389K

5,879 claims · 3.0%

Your Cost: $66.23/claim|Median: $57.39
1.2× median
D2391Normal range

Resin-based composite, one surface, posterior

$359K

5,995 claims · 2.8%

Your Cost: $59.89/claim|Median: $54.60
1.1× median
D0330Normal range

Panoramic radiographic image

$319K

6,646 claims · 2.5%

Your Cost: $48.03/claim|Median: $37.36
1.3× median
D0272Normal range

Bitewings, two radiographic images

$266K

15K claims · 2.1%

Your Cost: $18.14/claim|Median: $15.81
1.1× median
00170Top 10%

Anesthesia for intraoral procedures

$253K

790 claims · 2.0%

Your Cost: $320.82/claim|Median: $132.89
2.4× median
D9230Normal range

Inhalation of nitrous oxide/analgesia, anxiolysis

$225K

8,296 claims · 1.8%

Your Cost: $27.12/claim|Median: $26.24
1.0× median
D9223Top 25%

Deep sedation/general anesthesia, each additional 15 min

$204K

651 claims · 1.6%

Your Cost: $313.45/claim|Median: $107.14
2.9× median
D0274Top 25%

Bitewings, four radiographic images

$203K

6,729 claims · 1.6%

Your Cost: $30.15/claim|Median: $22.54
1.3× median
D0220Top 25%

Intraoral periapical radiographic image, first film

$157K

10K claims · 1.2%

Your Cost: $15.11/claim|Median: $10.51
1.4× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$146K

4,849 claims · 1.1%

Your Cost: $30.20/claim|Median: $32.07
0.9× median
D0140Normal range

Limited oral evaluation, problem focused

$108K

3,583 claims · 0.8%

Your Cost: $30.16/claim|Median: $27.07
1.1× median
D0603Normal range

$103K

11K claims · 0.8%

Your Cost: $9.07/claim|Median: $6.54
1.4× median
D0601Normal range

$94K

10K claims · 0.7%

Your Cost: $9.10/claim|Median: $7.50
1.2× median
D1510Normal range

$84K

702 claims · 0.7%

Your Cost: $119.52/claim|Median: $147.00
0.8× median
D8080Normal range

Comprehensive orthodontic treatment, adolescent dentition

$78K

71 claims · 0.6%

Your Cost: $1,092.54/claim|Median: $968.00
1.1× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$72K

2,371 claims · 0.6%

Your Cost: $30.41/claim|Median: $57.30
0.5× median
D7240Normal range

Extraction, impacted tooth, complete bony

$70K

319 claims · 0.5%

Your Cost: $219.80/claim|Median: $231.00
1.0× median
D7111Top 25%

$62K

1,023 claims · 0.5%

Your Cost: $60.19/claim|Median: $49.49
1.2× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$57K

7,473 claims · 0.4%

Your Cost: $7.58/claim|Median: $7.33
1.0× median
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