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Provider 1629089909

NPI: 1629089909Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$11.5M

$11,521,213

Total Claims

692K

Beneficiaries

534K

1.3 claims/patient

Avg Cost/Claim

$17

Monthly Spending Trend

Yearly Spending

2018
$1.8M
+3%
2019
$1.8M
-41%
2020
$1.1M
+33%
2021
$1.4M
+33%
2022
$1.9M
-15%
2023
$1.6M
+21%
2024
$1.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (D1351 (Sealant, per tooth)) accounts for 20% of total spending.

D1351Normal range

Sealant, per tooth

$2.3M

169K claims · 19.6%

Your Cost: $13.40/claim|Median: $26.10
0.5× median
D1120Normal range

Prophylaxis, adult

$1.6M

84K claims · 13.9%

Your Cost: $19.11/claim|Median: $33.86
0.6× median
D0120Normal range

Periodic oral evaluation, established patient

$1.3M

89K claims · 11.6%

Your Cost: $15.01/claim|Median: $24.34
0.6× median
D8670Normal range

Periodic orthodontic treatment visit

$1.2M

35K claims · 10.3%

Your Cost: $34.02/claim|Median: $185.01
0.2× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$975K

30K claims · 8.5%

Your Cost: $32.50/claim|Median: $71.00
0.5× median
D1208Normal range

Topical application of fluoride, excluding varnish

$612K

87K claims · 5.3%

Your Cost: $7.06/claim|Median: $14.36
0.5× median
D2391Normal range

Resin-based composite, one surface, posterior

$512K

19K claims · 4.4%

Your Cost: $27.42/claim|Median: $54.60
0.5× median
D8080Normal range

Comprehensive orthodontic treatment, adolescent dentition

$410K

786 claims · 3.6%

Your Cost: $521.48/claim|Median: $968.00
0.5× median
D0330Normal range

Panoramic radiographic image

$332K

17K claims · 2.9%

Your Cost: $19.05/claim|Median: $37.36
0.5× median
D7140Normal range

Extraction, erupted tooth or exposed root

$318K

11K claims · 2.8%

Your Cost: $29.72/claim|Median: $57.39
0.5× median
D0273Normal range

$258K

37K claims · 2.2%

Your Cost: $6.96/claim|Median: $17.25
0.4× median
D8660Normal range

$239K

8,347 claims · 2.1%

Your Cost: $28.68/claim|Median: $67.74
0.4× median
D8680Top 25%

$171K

276 claims · 1.5%

Your Cost: $619.86/claim|Median: $174.00
3.6× median
D1110Normal range

Prophylaxis, adult cleaning

$156K

10K claims · 1.4%

Your Cost: $15.24/claim|Median: $43.38
0.4× median
D0603Normal range

$154K

27K claims · 1.3%

Your Cost: $5.75/claim|Median: $6.54
0.9× median
D1206Normal range

Topical application of fluoride varnish

$113K

7,894 claims · 1.0%

Your Cost: $14.28/claim|Median: $18.12
0.8× median
D0140Normal range

Limited oral evaluation, problem focused

$100K

7,452 claims · 0.9%

Your Cost: $13.44/claim|Median: $27.07
0.5× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$85K

2,335 claims · 0.7%

Your Cost: $36.36/claim|Median: $84.26
0.4× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$82K

5,291 claims · 0.7%

Your Cost: $15.42/claim|Median: $32.07
0.5× median
D7111Normal range

$80K

3,090 claims · 0.7%

Your Cost: $25.93/claim|Median: $49.49
0.5× median
D2930Normal range

Prefabricated stainless steel crown, primary tooth

$80K

980 claims · 0.7%

Your Cost: $81.16/claim|Median: $120.85
0.7× median
D0602Normal range

$77K

14K claims · 0.7%

Your Cost: $5.51/claim|Median: $6.95
0.8× median
D2750Normal range

Crown, porcelain fused to high noble metal

$68K

206 claims · 0.6%

Your Cost: $329.20/claim|Median: $445.23
0.7× median
D3330Normal range

Endodontic therapy, molar (excluding final restoration)

$61K

267 claims · 0.5%

Your Cost: $226.85/claim|Median: $463.40
0.5× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$43K

3,261 claims · 0.4%

Your Cost: $13.18/claim|Median: $57.30
0.2× median
D0272Normal range

Bitewings, two radiographic images

$36K

7,242 claims · 0.3%

Your Cost: $5.02/claim|Median: $15.81
0.3× median
D2331Normal range

Resin-based composite filling, two surfaces, anterior

$33K

1,004 claims · 0.3%

Your Cost: $32.57/claim|Median: $73.58
0.4× median
D3220Normal range

Therapeutic pulpotomy

$32K

976 claims · 0.3%

Your Cost: $32.36/claim|Median: $81.27
0.4× median
D2330Normal range

Resin-based composite filling, one surface, anterior

$31K

1,102 claims · 0.3%

Your Cost: $27.96/claim|Median: $66.63
0.4× median
D9310Normal range

$22K

2,292 claims · 0.2%

Your Cost: $9.63/claim|Median: $46.20
0.2× median
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