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Provider 1629129242

NPI: 1629129242Share
Active Billing Period:2018-01→2024-12(82 months)

Total Paid

$18.0M

$17,996,774

Total Claims

528K

Beneficiaries

452K

1.2 claims/patient

Avg Cost/Claim

$34

Monthly Spending Trend

Yearly Spending

2018
$3.8M
-8%
2019
$3.5M
-49%
2020
$1.8M
+16%
2021
$2.1M
-21%
2022
$1.6M
+51%
2023
$2.5M
+9%
2024
$2.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (D1120 (Prophylaxis, adult)) accounts for 16% of total spending.

D1120Normal range

Prophylaxis, adult

$2.9M

84K claims · 15.9%

Your Cost: $34.06/claim|Median: $33.86
1.0× median
D0120Normal range

Periodic oral evaluation, established patient

$2.6M

107K claims · 14.7%

Your Cost: $24.65/claim|Median: $24.34
1.0× median
D1208Top 25%

Topical application of fluoride, excluding varnish

$2.1M

101K claims · 11.7%

Your Cost: $20.97/claim|Median: $14.36
1.5× median
D1351Normal range

Sealant, per tooth

$1.7M

59K claims · 9.7%

Your Cost: $29.72/claim|Median: $26.10
1.1× median
D1110Normal range

Prophylaxis, adult cleaning

$1.3M

29K claims · 7.1%

Your Cost: $43.67/claim|Median: $43.38
1.0× median
D2391Normal range

Resin-based composite, one surface, posterior

$1.1M

18K claims · 6.4%

Your Cost: $62.29/claim|Median: $54.60
1.1× median
D0210Top 25%

Intraoral, complete series of radiographic images

$1.1M

19K claims · 6.0%

Your Cost: $58.39/claim|Median: $46.33
1.3× median
D2930Normal range

Prefabricated stainless steel crown, primary tooth

$756K

6,645 claims · 4.2%

Your Cost: $113.79/claim|Median: $120.85
0.9× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$567K

7,663 claims · 3.2%

Your Cost: $74.01/claim|Median: $71.00
1.0× median
D2140Top 25%

Amalgam, one surface, primary or permanent

$549K

8,725 claims · 3.1%

Your Cost: $62.96/claim|Median: $52.77
1.2× median
D0272Normal range

Bitewings, two radiographic images

$526K

30K claims · 2.9%

Your Cost: $17.56/claim|Median: $15.81
1.1× median
D3220Normal range

Therapeutic pulpotomy

$516K

6,164 claims · 2.9%

Your Cost: $83.67/claim|Median: $81.27
1.0× median
D0274Normal range

Bitewings, four radiographic images

$404K

15K claims · 2.2%

Your Cost: $26.47/claim|Median: $22.54
1.2× median
D0330Normal range

Panoramic radiographic image

$384K

8,364 claims · 2.1%

Your Cost: $45.88/claim|Median: $37.36
1.2× median
D2150Top 25%

Amalgam, two surfaces, primary or permanent

$313K

4,171 claims · 1.7%

Your Cost: $75.09/claim|Median: $66.00
1.1× median
D3330Normal range

Endodontic therapy, molar (excluding final restoration)

$267K

460 claims · 1.5%

Your Cost: $580.67/claim|Median: $463.40
1.3× median
D1206Normal range

Topical application of fluoride varnish

$259K

12K claims · 1.4%

Your Cost: $21.07/claim|Median: $18.12
1.2× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$185K

6,199 claims · 1.0%

Your Cost: $29.85/claim|Median: $32.07
0.9× median
D7140Normal range

Extraction, erupted tooth or exposed root

$134K

2,183 claims · 0.7%

Your Cost: $61.57/claim|Median: $57.39
1.1× median
D2931Top 25%

$88K

616 claims · 0.5%

Your Cost: $142.49/claim|Median: $125.71
1.1× median
D2950Normal range

$83K

700 claims · 0.5%

Your Cost: $118.28/claim|Median: $123.37
1.0× median
D2330Normal range

Resin-based composite filling, one surface, anterior

$59K

949 claims · 0.3%

Your Cost: $61.83/claim|Median: $66.63
0.9× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$21K

257 claims · 0.1%

Your Cost: $83.19/claim|Median: $84.26
1.0× median
D0140Normal range

Limited oral evaluation, problem focused

$14K

579 claims · 0.1%

Your Cost: $23.66/claim|Median: $27.07
0.9× median
D2390Normal range

$8K

49 claims · 0.0%

Your Cost: $163.78/claim|Median: $170.27
1.0× median
D0220Top 25%

Intraoral periapical radiographic image, first film

$4K

288 claims · 0.0%

Your Cost: $12.29/claim|Median: $10.51
1.2× median
D1354Normal range

$2K

206 claims · 0.0%

Your Cost: $9.91/claim|Median: $12.52
0.8× median
D9110Normal range

$2K

32 claims · 0.0%

Your Cost: $48.28/claim|Median: $38.08
1.3× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$2K

74 claims · 0.0%

Your Cost: $20.56/claim|Median: $57.30
0.4× median
D9995Normal range

$0

43 claims · 0.0%

Your Cost: $0.00/claim|Median: $13.12
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