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Provider 1669738902

NPI: 1669738902Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$7.5M

$7,533,104

Total Claims

155K

Beneficiaries

133K

1.2 claims/patient

Avg Cost/Claim

$49

Monthly Spending Trend

Yearly Spending

2018
$1.1M
+4%
2019
$1.2M
-30%
2020
$811K
+48%
2021
$1.2M
-6%
2022
$1.1M
+0%
2023
$1.1M
-11%
2024
$1.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (D5110) accounts for 22% of total spending.

D5110Normal range

$1.6M

3,168 claims · 21.5%

Your Cost: $511.94/claim|Median: $472.15
1.1× median
D5120Normal range

$1.1M

2,115 claims · 14.3%

Your Cost: $510.88/claim|Median: $468.71
1.1× median
D1110Normal range

Prophylaxis, adult cleaning

$539K

15K claims · 7.2%

Your Cost: $36.92/claim|Median: $43.38
0.9× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$513K

7,150 claims · 6.8%

Your Cost: $71.78/claim|Median: $71.00
1.0× median
D0120Normal range

Periodic oral evaluation, established patient

$348K

19K claims · 4.6%

Your Cost: $18.24/claim|Median: $24.34
0.7× median
D1208Normal range

Topical application of fluoride, excluding varnish

$346K

23K claims · 4.6%

Your Cost: $15.22/claim|Median: $14.36
1.1× median
D2752Normal range

$305K

781 claims · 4.0%

Your Cost: $390.51/claim|Median: $423.42
0.9× median
D0210Normal range

Intraoral, complete series of radiographic images

$247K

5,067 claims · 3.3%

Your Cost: $48.65/claim|Median: $46.33
1.1× median
D7210Normal range

Extraction, erupted tooth, surgical approach

$241K

2,498 claims · 3.2%

Your Cost: $96.57/claim|Median: $109.42
0.9× median
D0274Normal range

Bitewings, four radiographic images

$222K

9,250 claims · 3.0%

Your Cost: $24.03/claim|Median: $22.54
1.1× median
D4910Normal range

$214K

3,542 claims · 2.8%

Your Cost: $60.52/claim|Median: $75.56
0.8× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$214K

9,396 claims · 2.8%

Your Cost: $22.80/claim|Median: $32.07
0.7× median
D0140Normal range

Limited oral evaluation, problem focused

$190K

7,711 claims · 2.5%

Your Cost: $24.60/claim|Median: $27.07
0.9× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$185K

2,466 claims · 2.5%

Your Cost: $74.88/claim|Median: $84.26
0.9× median
D1351Normal range

Sealant, per tooth

$149K

7,570 claims · 2.0%

Your Cost: $19.70/claim|Median: $26.10
0.8× median
D5214Normal range

$143K

286 claims · 1.9%

Your Cost: $498.79/claim|Median: $561.58
0.9× median
D7140Normal range

Extraction, erupted tooth or exposed root

$139K

2,759 claims · 1.8%

Your Cost: $50.42/claim|Median: $57.39
0.9× median
D1120Normal range

Prophylaxis, adult

$138K

5,071 claims · 1.8%

Your Cost: $27.12/claim|Median: $33.86
0.8× median
D2391Normal range

Resin-based composite, one surface, posterior

$112K

2,184 claims · 1.5%

Your Cost: $51.21/claim|Median: $54.60
0.9× median
D2950Normal range

$100K

1,013 claims · 1.3%

Your Cost: $98.96/claim|Median: $123.37
0.8× median
D2332Normal range

$88K

1,154 claims · 1.2%

Your Cost: $76.44/claim|Median: $87.21
0.9× median
D0220Normal range

Intraoral periapical radiographic image, first film

$66K

6,697 claims · 0.9%

Your Cost: $9.81/claim|Median: $10.51
0.9× median
D0330Normal range

Panoramic radiographic image

$63K

1,823 claims · 0.8%

Your Cost: $34.75/claim|Median: $37.36
0.9× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$50K

6,540 claims · 0.7%

Your Cost: $7.68/claim|Median: $7.33
1.0× median
D5213Normal range

$50K

107 claims · 0.7%

Your Cost: $466.62/claim|Median: $549.94
0.8× median
D4341Normal range

Periodontal scaling, per quadrant

$34K

372 claims · 0.4%

Your Cost: $90.39/claim|Median: $70.00
1.3× median
D5750Normal range

$26K

164 claims · 0.4%

Your Cost: $161.46/claim|Median: $191.03
0.8× median
D0603Normal range

$24K

5,348 claims · 0.3%

Your Cost: $4.55/claim|Median: $6.54
0.7× median
D2740Normal range

Crown, porcelain/ceramic substrate

$20K

53 claims · 0.3%

Your Cost: $382.99/claim|Median: $509.58
0.8× median
D2335Normal range

$15K

188 claims · 0.2%

Your Cost: $81.86/claim|Median: $105.06
0.8× median
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