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Provider 1659412930

NPI: 1659412930Share
Active Billing Period:2019-12→2024-11(59 months)

Total Paid

$11.3M

$11,328,199

Total Claims

164K

Beneficiaries

109K

1.5 claims/patient

Avg Cost/Claim

$69

Monthly Spending Trend

Yearly Spending

2019
$83K
+1796%
2020
$1.6M
+43%
2021
$2.2M
+15%
2022
$2.6M
-2%
2023
$2.5M
-9%
2024
$2.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 29 distinct procedure codes. The top code (D2930 (Prefabricated stainless steel crown, primary tooth)) accounts for 23% of total spending.

D2930Top 25%

Prefabricated stainless steel crown, primary tooth

$2.6M

17K claims · 22.9%

Your Cost: $154.59/claim|Median: $120.85
1.3× median
D3220Top 25%

Therapeutic pulpotomy

$1.4M

15K claims · 12.6%

Your Cost: $97.85/claim|Median: $81.27
1.2× median
D7140Top 5%

Extraction, erupted tooth or exposed root

$1.2M

8,646 claims · 10.9%

Your Cost: $142.81/claim|Median: $57.39
2.5× median
D1120Top 5%

Prophylaxis, adult

$878K

15K claims · 7.7%

Your Cost: $59.16/claim|Median: $33.86
1.7× median
D2150Top 25%

Amalgam, two surfaces, primary or permanent

$702K

8,695 claims · 6.2%

Your Cost: $80.73/claim|Median: $66.00
1.2× median
D0150Top 5%

Comprehensive oral evaluation, new or established patient

$695K

9,216 claims · 6.1%

Your Cost: $75.40/claim|Median: $32.07
2.4× median
D1351Normal range

Sealant, per tooth

$542K

19K claims · 4.8%

Your Cost: $28.77/claim|Median: $26.10
1.1× median
D0120Top 25%

Periodic oral evaluation, established patient

$401K

9,451 claims · 3.5%

Your Cost: $42.39/claim|Median: $24.34
1.7× median
D2140Top 25%

Amalgam, one surface, primary or permanent

$400K

6,177 claims · 3.5%

Your Cost: $64.78/claim|Median: $52.77
1.2× median
D4220Normal range

$313K

1,901 claims · 2.8%

Your Cost: $164.86/claim|Median: $390.32
0.4× median
D2160Top 25%

Amalgam filling, three surfaces

$254K

2,553 claims · 2.2%

Your Cost: $99.58/claim|Median: $78.55
1.3× median
D0210Top 10%

Intraoral, complete series of radiographic images

$249K

3,383 claims · 2.2%

Your Cost: $73.72/claim|Median: $46.33
1.6× median
D1203Top 25%

$183K

9,039 claims · 1.6%

Your Cost: $20.22/claim|Median: $19.37
1.0× median
D1110Normal range

Prophylaxis, adult cleaning

$155K

3,070 claims · 1.4%

Your Cost: $50.49/claim|Median: $43.38
1.2× median
D9230Normal range

Inhalation of nitrous oxide/analgesia, anxiolysis

$151K

4,597 claims · 1.3%

Your Cost: $32.77/claim|Median: $26.24
1.2× median
D0274Top 10%

Bitewings, four radiographic images

$147K

4,179 claims · 1.3%

Your Cost: $35.14/claim|Median: $22.54
1.6× median
D0220Top 25%

Intraoral periapical radiographic image, first film

$142K

9,662 claims · 1.3%

Your Cost: $14.71/claim|Median: $10.51
1.4× median
D1510Top 5%

$138K

601 claims · 1.2%

Your Cost: $229.66/claim|Median: $147.00
1.6× median
D2335Top 25%

$104K

678 claims · 0.9%

Your Cost: $153.24/claim|Median: $105.06
1.5× median
D0230Top 25%

Intraoral, periapical radiographic image, first film

$102K

8,532 claims · 0.9%

Your Cost: $11.95/claim|Median: $7.33
1.6× median
D0272Top 10%

Bitewings, two radiographic images

$102K

4,136 claims · 0.9%

Your Cost: $24.62/claim|Median: $15.81
1.6× median
D0140Top 5%

Limited oral evaluation, problem focused

$91K

1,421 claims · 0.8%

Your Cost: $63.88/claim|Median: $27.07
2.4× median
D2332Top 25%

$85K

695 claims · 0.8%

Your Cost: $122.52/claim|Median: $87.21
1.4× median
D7210Top 25%

Extraction, erupted tooth, surgical approach

$79K

537 claims · 0.7%

Your Cost: $146.97/claim|Median: $109.42
1.3× median
D2330Top 25%

Resin-based composite filling, one surface, anterior

$57K

735 claims · 0.5%

Your Cost: $78.22/claim|Median: $66.63
1.2× median
D2161Top 25%

$43K

359 claims · 0.4%

Your Cost: $120.22/claim|Median: $81.37
1.5× median
D3120Top 5%

$35K

853 claims · 0.3%

Your Cost: $41.44/claim|Median: $24.98
1.7× median
D2331Top 25%

Resin-based composite filling, two surfaces, anterior

$18K

186 claims · 0.2%

Your Cost: $97.34/claim|Median: $73.58
1.3× median
D4341Top 25%

Periodontal scaling, per quadrant

$5K

30 claims · 0.0%

Your Cost: $150.00/claim|Median: $70.00
2.1× median
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