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Provider 1619101540

NPI: 1619101540Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$11.2M

$11,204,789

Total Claims

464K

Beneficiaries

252K

1.8 claims/patient

Avg Cost/Claim

$24

Monthly Spending Trend

Yearly Spending

2018
$1.7M
+2%
2019
$1.7M
-26%
2020
$1.3M
+23%
2021
$1.6M
+15%
2022
$1.8M
-10%
2023
$1.6M
-13%
2024
$1.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (D0120 (Periodic oral evaluation, established patient)) accounts for 16% of total spending.

D0120Top 10%

Periodic oral evaluation, established patient

$1.8M

33K claims · 16.4%

Your Cost: $55.11/claim|Median: $24.34
2.3× median
D1120Normal range

Prophylaxis, adult

$1.4M

36K claims · 12.2%

Your Cost: $38.52/claim|Median: $33.86
1.1× median
D2150Normal range

Amalgam, two surfaces, primary or permanent

$982K

15K claims · 8.8%

Your Cost: $67.00/claim|Median: $66.00
1.0× median
D2140Normal range

Amalgam, one surface, primary or permanent

$960K

18K claims · 8.6%

Your Cost: $54.44/claim|Median: $52.77
1.0× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$873K

202K claims · 7.8%

Your Cost: $4.33/claim|Median: $7.33
0.6× median
D7140Normal range

Extraction, erupted tooth or exposed root

$767K

13K claims · 6.8%

Your Cost: $57.31/claim|Median: $57.39
1.0× median
D2930Normal range

Prefabricated stainless steel crown, primary tooth

$660K

5,591 claims · 5.9%

Your Cost: $118.09/claim|Median: $120.85
1.0× median
D3220Top 25%

Therapeutic pulpotomy

$548K

5,519 claims · 4.9%

Your Cost: $99.26/claim|Median: $81.27
1.2× median
D1208Normal range

Topical application of fluoride, excluding varnish

$487K

38K claims · 4.3%

Your Cost: $12.88/claim|Median: $14.36
0.9× median
D1351Normal range

Sealant, per tooth

$473K

17K claims · 4.2%

Your Cost: $27.16/claim|Median: $26.10
1.0× median
D8670Top 25%

Periodic orthodontic treatment visit

$404K

1,406 claims · 3.6%

Your Cost: $287.25/claim|Median: $185.01
1.6× median
D0272Normal range

Bitewings, two radiographic images

$341K

29K claims · 3.0%

Your Cost: $11.77/claim|Median: $15.81
0.7× median
D2160Normal range

Amalgam filling, three surfaces

$226K

2,844 claims · 2.0%

Your Cost: $79.62/claim|Median: $78.55
1.0× median
D1310Top 25%

Nutritional counseling for control of dental disease

$208K

4,572 claims · 1.9%

Your Cost: $45.50/claim|Median: $40.52
1.1× median
D0350Normal range

$197K

19K claims · 1.8%

Your Cost: $10.43/claim|Median: $9.73
1.1× median
D0150Top 10%

Comprehensive oral evaluation, new or established patient

$188K

2,935 claims · 1.7%

Your Cost: $63.91/claim|Median: $32.07
2.0× median
D1110Top 5%

Prophylaxis, adult cleaning

$141K

1,611 claims · 1.3%

Your Cost: $87.30/claim|Median: $43.38
2.0× median
D2330Top 25%

Resin-based composite filling, one surface, anterior

$127K

1,644 claims · 1.1%

Your Cost: $77.01/claim|Median: $66.63
1.2× median
D0220Normal range

Intraoral periapical radiographic image, first film

$118K

10K claims · 1.0%

Your Cost: $11.67/claim|Median: $10.51
1.1× median
D9993Top 25%

$73K

1,145 claims · 0.7%

Your Cost: $64.17/claim|Median: $62.07
1.0× median
D0603Top 10%

$58K

3,933 claims · 0.5%

Your Cost: $14.83/claim|Median: $6.54
2.3× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$57K

965 claims · 0.5%

Your Cost: $59.16/claim|Median: $57.30
1.0× median
D4341Normal range

Periodontal scaling, per quadrant

$28K

393 claims · 0.2%

Your Cost: $70.00/claim|Median: $70.00
1.0× median
D0140Normal range

Limited oral evaluation, problem focused

$27K

764 claims · 0.2%

Your Cost: $34.86/claim|Median: $27.07
1.3× median
D2331Normal range

Resin-based composite filling, two surfaces, anterior

$16K

193 claims · 0.1%

Your Cost: $80.54/claim|Median: $73.58
1.1× median
D0210Normal range

Intraoral, complete series of radiographic images

$14K

294 claims · 0.1%

Your Cost: $47.65/claim|Median: $46.33
1.0× median
D0340Normal range

$5K

101 claims · 0.0%

Your Cost: $50.00/claim|Median: $49.44
1.0× median
D0601Top 25%

$5K

336 claims · 0.0%

Your Cost: $14.82/claim|Median: $7.50
2.0× median
D7210Normal range

Extraction, erupted tooth, surgical approach

$4K

38 claims · 0.0%

Your Cost: $112.74/claim|Median: $109.42
1.0× median
D0330Normal range

Panoramic radiographic image

$4K

129 claims · 0.0%

Your Cost: $30.00/claim|Median: $37.36
0.8× median
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