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Provider 1700969391

NPI: 1700969391Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$10.7M

$10,710,975

Total Claims

235K

Beneficiaries

189K

1.2 claims/patient

Avg Cost/Claim

$46

Monthly Spending Trend

Yearly Spending

2018
$3.5M
-37%
2019
$2.2M
-70%
2020
$674K
+34%
2021
$906K
+4%
2022
$945K
+44%
2023
$1.4M
-21%
2024
$1.1M

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 34% of total spending.

D2930Top 25%

Prefabricated stainless steel crown, primary tooth

$3.6M

21K claims · 34.0%

Your Cost: $174.81/claim|Median: $120.85
1.4× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$1.5M

17K claims · 13.7%

Your Cost: $87.59/claim|Median: $71.00
1.2× median
D2391Normal range

Resin-based composite, one surface, posterior

$879K

15K claims · 8.2%

Your Cost: $57.36/claim|Median: $54.60
1.1× median
D2332Top 5%

$640K

4,027 claims · 6.0%

Your Cost: $158.88/claim|Median: $87.21
1.8× median
D0120Normal range

Periodic oral evaluation, established patient

$564K

24K claims · 5.3%

Your Cost: $23.10/claim|Median: $24.34
0.9× median
D1206Normal range

Topical application of fluoride varnish

$470K

29K claims · 4.4%

Your Cost: $16.50/claim|Median: $18.12
0.9× median
D1120Normal range

Prophylaxis, adult

$447K

20K claims · 4.2%

Your Cost: $22.53/claim|Median: $33.86
0.7× median
D7140Normal range

Extraction, erupted tooth or exposed root

$373K

5,465 claims · 3.5%

Your Cost: $68.34/claim|Median: $57.39
1.2× median
D1351Normal range

Sealant, per tooth

$244K

12K claims · 2.3%

Your Cost: $20.43/claim|Median: $26.10
0.8× median
D8080Normal range

Comprehensive orthodontic treatment, adolescent dentition

$231K

1,006 claims · 2.2%

Your Cost: $230.01/claim|Median: $968.00
0.2× median
D9230Normal range

Inhalation of nitrous oxide/analgesia, anxiolysis

$221K

11K claims · 2.1%

Your Cost: $19.85/claim|Median: $26.24
0.8× median
D1110Normal range

Prophylaxis, adult cleaning

$216K

6,083 claims · 2.0%

Your Cost: $35.52/claim|Median: $43.38
0.8× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$169K

4,085 claims · 1.6%

Your Cost: $41.36/claim|Median: $32.07
1.3× median
D0330Normal range

Panoramic radiographic image

$162K

4,266 claims · 1.5%

Your Cost: $37.96/claim|Median: $37.36
1.0× median
D9999Normal range

Unspecified adjunctive procedure, by report

$137K

5,081 claims · 1.3%

Your Cost: $26.90/claim|Median: $37.60
0.7× median
D0272Normal range

Bitewings, two radiographic images

$135K

14K claims · 1.3%

Your Cost: $9.77/claim|Median: $15.81
0.6× median
D0220Normal range

Intraoral periapical radiographic image, first film

$121K

15K claims · 1.1%

Your Cost: $7.91/claim|Median: $10.51
0.8× median
D2929Top 25%

$111K

471 claims · 1.0%

Your Cost: $235.34/claim|Median: $154.83
1.5× median
D2330Top 25%

Resin-based composite filling, one surface, anterior

$108K

1,387 claims · 1.0%

Your Cost: $77.57/claim|Median: $66.63
1.2× median
D3220Top 10%

Therapeutic pulpotomy

$105K

858 claims · 1.0%

Your Cost: $122.69/claim|Median: $81.27
1.5× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$95K

1,339 claims · 0.9%

Your Cost: $70.78/claim|Median: $84.26
0.8× median
D0274Normal range

Bitewings, four radiographic images

$50K

3,649 claims · 0.5%

Your Cost: $13.67/claim|Median: $22.54
0.6× median
D0140Normal range

Limited oral evaluation, problem focused

$39K

2,002 claims · 0.4%

Your Cost: $19.61/claim|Median: $27.07
0.7× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$33K

14K claims · 0.3%

Your Cost: $2.36/claim|Median: $7.33
0.3× median
D1999Normal range

$19K

1,454 claims · 0.2%

Your Cost: $13.03/claim|Median: $11.95
1.1× median
D7111Normal range

$10K

346 claims · 0.1%

Your Cost: $28.61/claim|Median: $49.49
0.6× median
D2331Normal range

Resin-based composite filling, two surfaces, anterior

$9K

108 claims · 0.1%

Your Cost: $80.71/claim|Median: $73.58
1.1× median
D0270Normal range

$7K

1,267 claims · 0.1%

Your Cost: $5.38/claim|Median: $5.46
1.0× median
D1510Normal range

$3K

43 claims · 0.0%

Your Cost: $76.23/claim|Median: $147.00
0.5× median
D9248Normal range

$650

13 claims · 0.0%

Your Cost: $50.00/claim|Median: $92.49
0.5× median
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