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Provider 1679105605

NPI: 1679105605Share
Active Billing Period:2021-04→2024-12(45 months)

Total Paid

$12.7M

$12,726,580

Total Claims

419K

Beneficiaries

257K

1.6 claims/patient

Avg Cost/Claim

$30

Monthly Spending Trend

Yearly Spending

2021
$864K
+232%
2022
$2.9M
+62%
2023
$4.6M
-7%
2024
$4.3M

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 13% of total spending.

D2930Normal range

Prefabricated stainless steel crown, primary tooth

$1.6M

14K claims · 12.7%

Your Cost: $118.78/claim|Median: $120.85
1.0× median
D1120Top 10%

Prophylaxis, adult

$1.6M

33K claims · 12.7%

Your Cost: $49.44/claim|Median: $33.86
1.5× median
D0120Top 5%

Periodic oral evaluation, established patient

$1.4M

21K claims · 11.4%

Your Cost: $68.62/claim|Median: $24.34
2.8× median
D1310Normal range

Nutritional counseling for control of dental disease

$745K

17K claims · 5.9%

Your Cost: $44.64/claim|Median: $40.52
1.1× median
D3220Top 25%

Therapeutic pulpotomy

$716K

7,267 claims · 5.6%

Your Cost: $98.50/claim|Median: $81.27
1.2× median
D1208Top 25%

Topical application of fluoride, excluding varnish

$647K

32K claims · 5.1%

Your Cost: $20.36/claim|Median: $14.36
1.4× median
D9223Top 25%

Deep sedation/general anesthesia, each additional 15 min

$622K

2,362 claims · 4.9%

Your Cost: $263.15/claim|Median: $107.14
2.5× median
D0150Top 5%

Comprehensive oral evaluation, new or established patient

$590K

8,742 claims · 4.6%

Your Cost: $67.47/claim|Median: $32.07
2.1× median
D0350Normal range

$535K

70K claims · 4.2%

Your Cost: $7.68/claim|Median: $9.73
0.8× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$533K

8,044 claims · 4.2%

Your Cost: $66.20/claim|Median: $71.00
0.9× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$470K

113K claims · 3.7%

Your Cost: $4.16/claim|Median: $7.33
0.6× median
D7140Normal range

Extraction, erupted tooth or exposed root

$462K

8,153 claims · 3.6%

Your Cost: $56.67/claim|Median: $57.39
1.0× median
D9230Top 25%

Inhalation of nitrous oxide/analgesia, anxiolysis

$359K

9,020 claims · 2.8%

Your Cost: $39.76/claim|Median: $26.24
1.5× median
D1351Top 25%

Sealant, per tooth

$348K

9,875 claims · 2.7%

Your Cost: $35.24/claim|Median: $26.10
1.4× median
D2391Normal range

Resin-based composite, one surface, posterior

$293K

5,459 claims · 2.3%

Your Cost: $53.73/claim|Median: $54.60
1.0× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$282K

4,038 claims · 2.2%

Your Cost: $69.95/claim|Median: $57.30
1.2× median
D9222Top 25%

Deep sedation/general anesthesia, first 15 minutes

$206K

1,687 claims · 1.6%

Your Cost: $122.26/claim|Median: $90.28
1.4× median
D0603Top 25%

$193K

13K claims · 1.5%

Your Cost: $14.74/claim|Median: $6.54
2.3× median
D0220Normal range

Intraoral periapical radiographic image, first film

$184K

16K claims · 1.4%

Your Cost: $11.83/claim|Median: $10.51
1.1× median
D1510Top 25%

$163K

800 claims · 1.3%

Your Cost: $203.48/claim|Median: $147.00
1.4× median
D0274Normal range

Bitewings, four radiographic images

$158K

7,417 claims · 1.2%

Your Cost: $21.29/claim|Median: $22.54
0.9× median
D3230Normal range

$153K

1,559 claims · 1.2%

Your Cost: $98.36/claim|Median: $98.27
1.0× median
D0272Normal range

Bitewings, two radiographic images

$100K

8,481 claims · 0.8%

Your Cost: $11.75/claim|Median: $15.81
0.7× median
D0330Normal range

Panoramic radiographic image

$75K

2,598 claims · 0.6%

Your Cost: $29.03/claim|Median: $37.36
0.8× median
D2330Top 25%

Resin-based composite filling, one surface, anterior

$74K

947 claims · 0.6%

Your Cost: $78.13/claim|Median: $66.63
1.2× median
D9430Normal range

$64K

2,012 claims · 0.5%

Your Cost: $31.98/claim|Median: $31.69
1.0× median
D0602Top 25%

$38K

2,778 claims · 0.3%

Your Cost: $13.74/claim|Median: $6.95
2.0× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$28K

345 claims · 0.2%

Your Cost: $79.80/claim|Median: $84.26
0.9× median
D0601Top 25%

$3K

228 claims · 0.0%

Your Cost: $14.87/claim|Median: $7.50
2.0× median
D2331Normal range

Resin-based composite filling, two surfaces, anterior

$2K

21 claims · 0.0%

Your Cost: $80.09/claim|Median: $73.58
1.1× median
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