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Provider 1639270846

NPI: 1639270846Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$16.9M

$16,859,712

Total Claims

301K

Beneficiaries

204K

1.5 claims/patient

Avg Cost/Claim

$56

Monthly Spending Trend

Yearly Spending

2018
$3.2M
-11%
2019
$2.9M
-48%
2020
$1.5M
+38%
2021
$2.1M
+16%
2022
$2.4M
+14%
2023
$2.7M
-21%
2024
$2.1M

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 15% of total spending.

D2930Normal range

Prefabricated stainless steel crown, primary tooth

$2.6M

23K claims · 15.4%

Your Cost: $114.57/claim|Median: $120.85
0.9× median
41899Normal range

Unlisted procedure, dentoalveolar structures

$1.9M

6,570 claims · 11.5%

Your Cost: $294.10/claim|Median: $763.43
0.4× median
D3220Normal range

Therapeutic pulpotomy

$1.4M

14K claims · 8.2%

Your Cost: $97.18/claim|Median: $81.27
1.2× median
D7140Normal range

Extraction, erupted tooth or exposed root

$1.3M

23K claims · 7.5%

Your Cost: $55.65/claim|Median: $57.39
1.0× median
D9420Normal range

$1.2M

17K claims · 7.3%

Your Cost: $73.12/claim|Median: $81.82
0.9× median
D0150Top 25%

Comprehensive oral evaluation, new or established patient

$861K

15K claims · 5.1%

Your Cost: $59.35/claim|Median: $32.07
1.9× median
D2330Normal range

Resin-based composite filling, one surface, anterior

$748K

9,902 claims · 4.4%

Your Cost: $75.50/claim|Median: $66.63
1.1× median
D7210Normal range

Extraction, erupted tooth, surgical approach

$590K

5,140 claims · 3.5%

Your Cost: $114.82/claim|Median: $109.42
1.0× median
D2150Normal range

Amalgam, two surfaces, primary or permanent

$576K

8,856 claims · 3.4%

Your Cost: $65.02/claim|Median: $66.00
1.0× median
D1120Normal range

Prophylaxis, adult

$463K

19K claims · 2.7%

Your Cost: $24.61/claim|Median: $33.86
0.7× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$413K

6,410 claims · 2.5%

Your Cost: $64.44/claim|Median: $71.00
0.9× median
D0120Top 10%

Periodic oral evaluation, established patient

$408K

8,871 claims · 2.4%

Your Cost: $46.02/claim|Median: $24.34
1.9× median
D2391Normal range

Resin-based composite, one surface, posterior

$379K

7,168 claims · 2.2%

Your Cost: $52.86/claim|Median: $54.60
1.0× median
D7240Normal range

Extraction, impacted tooth, complete bony

$350K

1,570 claims · 2.1%

Your Cost: $223.05/claim|Median: $231.00
1.0× median
D0210Normal range

Intraoral, complete series of radiographic images

$317K

6,869 claims · 1.9%

Your Cost: $46.20/claim|Median: $46.33
1.0× median
D9223Normal range

Deep sedation/general anesthesia, each additional 15 min

$284K

1,537 claims · 1.7%

Your Cost: $184.91/claim|Median: $107.14
1.7× median
D0330Normal range

Panoramic radiographic image

$226K

8,182 claims · 1.3%

Your Cost: $27.65/claim|Median: $37.36
0.7× median
D1110Top 10%

Prophylaxis, adult cleaning

$210K

2,622 claims · 1.2%

Your Cost: $80.08/claim|Median: $43.38
1.8× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$194K

36K claims · 1.1%

Your Cost: $5.34/claim|Median: $7.33
0.7× median
D7230Normal range

Extraction, impacted tooth, partial bony

$176K

951 claims · 1.0%

Your Cost: $185.10/claim|Median: $187.09
1.0× median
D9220Normal range

$168K

857 claims · 1.0%

Your Cost: $196.56/claim|Median: $215.77
0.9× median
D1351Normal range

Sealant, per tooth

$157K

5,973 claims · 0.9%

Your Cost: $26.26/claim|Median: $26.10
1.0× median
D1206Normal range

Topical application of fluoride varnish

$156K

16K claims · 0.9%

Your Cost: $9.66/claim|Median: $18.12
0.5× median
D0272Normal range

Bitewings, two radiographic images

$149K

13K claims · 0.9%

Your Cost: $11.36/claim|Median: $15.81
0.7× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$132K

1,707 claims · 0.8%

Your Cost: $77.17/claim|Median: $84.26
0.9× median
D2160Normal range

Amalgam filling, three surfaces

$131K

1,681 claims · 0.8%

Your Cost: $77.73/claim|Median: $78.55
1.0× median
D9430Normal range

$123K

3,933 claims · 0.7%

Your Cost: $31.27/claim|Median: $31.69
1.0× median
D2331Normal range

Resin-based composite filling, two surfaces, anterior

$122K

1,615 claims · 0.7%

Your Cost: $75.48/claim|Median: $73.58
1.0× median
D9222Normal range

Deep sedation/general anesthesia, first 15 minutes

$116K

978 claims · 0.7%

Your Cost: $118.49/claim|Median: $90.28
1.3× median
D0350Normal range

$107K

9,971 claims · 0.6%

Your Cost: $10.76/claim|Median: $9.73
1.1× median
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