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Provider 1043373244

NPI: 1043373244Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$17.5M

$17,535,827

Total Claims

623K

Beneficiaries

553K

1.1 claims/patient

Avg Cost/Claim

$28

Monthly Spending Trend

Yearly Spending

2018
$3.4M
-6%
2019
$3.2M
-29%
2020
$2.3M
-4%
2021
$2.2M
+22%
2022
$2.7M
-23%
2023
$2.1M
-17%
2024
$1.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (G0467 (Federally qualified health center visit, mental health)) accounts for 61% of total spending.

G0467Top 25%

Federally qualified health center visit, mental health

$10.6M

163K claims · 60.7%

Your Cost: $65.35/claim|Median: $21.91
3.0× median
G0466Normal range

$999K

15K claims · 5.7%

Your Cost: $68.49/claim|Median: $63.31
1.1× median
G0470Normal range

Chronic care management services, FQHC/RHC

$888K

14K claims · 5.1%

Your Cost: $64.45/claim|Median: $45.95
1.4× median
D0120Top 1%

Periodic oral evaluation, established patient

$633K

4,784 claims · 3.6%

Your Cost: $132.36/claim|Median: $24.34
5.4× median
D7140Top 5%

Extraction, erupted tooth or exposed root

$631K

5,486 claims · 3.6%

Your Cost: $115.04/claim|Median: $57.39
2.0× median
D1110Top 1%

Prophylaxis, adult cleaning

$616K

4,509 claims · 3.5%

Your Cost: $136.64/claim|Median: $43.38
3.1× median
D0150Top 1%

Comprehensive oral evaluation, new or established patient

$524K

3,879 claims · 3.0%

Your Cost: $134.97/claim|Median: $32.07
4.2× median
D0140Top 1%

Limited oral evaluation, problem focused

$394K

2,776 claims · 2.2%

Your Cost: $142.09/claim|Median: $27.07
5.2× median
D2392Top 10%

Resin-based composite, two surfaces, posterior

$343K

2,655 claims · 2.0%

Your Cost: $129.34/claim|Median: $71.00
1.8× median
D4355Top 5%

$217K

1,431 claims · 1.2%

Your Cost: $151.35/claim|Median: $64.42
2.3× median
D2391Top 5%

Resin-based composite, one surface, posterior

$211K

1,844 claims · 1.2%

Your Cost: $114.25/claim|Median: $54.60
2.1× median
G0468Top 25%

$203K

2,816 claims · 1.2%

Your Cost: $72.03/claim|Median: $43.74
1.6× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$187K

76K claims · 1.1%

Your Cost: $2.45/claim|Median: $37.81
0.1× median
99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$140K

37K claims · 0.8%

Your Cost: $3.77/claim|Median: $53.41
0.1× median
D2393Top 10%

Resin-based composite, three surfaces, posterior

$67K

436 claims · 0.4%

Your Cost: $153.93/claim|Median: $84.26
1.8× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$55K

18K claims · 0.3%

Your Cost: $3.05/claim|Median: $17.85
0.2× median
90651Normal range

HPV vaccine, 9-valent

$46K

3,207 claims · 0.3%

Your Cost: $14.26/claim|Median: $8.93
1.6× median
99393Normal range

Preventive medicine, established patient, age 5-11

$39K

7,844 claims · 0.2%

Your Cost: $4.94/claim|Median: $74.82
0.1× median
90832Normal range

Psychotherapy, 30 minutes

$39K

15K claims · 0.2%

Your Cost: $2.55/claim|Median: $41.28
0.1× median
99392Normal range

Preventive medicine, established patient, age 1-4

$36K

6,337 claims · 0.2%

Your Cost: $5.70/claim|Median: $75.18
0.1× median
D0210Normal range

Intraoral, complete series of radiographic images

$35K

3,462 claims · 0.2%

Your Cost: $10.24/claim|Median: $46.33
0.2× median
83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$32K

9,837 claims · 0.2%

Your Cost: $3.29/claim|Median: $5.50
0.6× median
84443Normal range

Thyroid stimulating hormone (TSH)

$31K

4,551 claims · 0.2%

Your Cost: $6.73/claim|Median: $9.87
0.7× median
99394Normal range

Preventive medicine, established patient, age 12-17

$29K

6,023 claims · 0.2%

Your Cost: $4.80/claim|Median: $80.15
0.1× median
99396Normal range

Preventive medicine, established patient, age 40-64

$28K

5,345 claims · 0.2%

Your Cost: $5.31/claim|Median: $76.06
0.1× median
99395Normal range

Preventive medicine, established patient, age 18-39

$25K

6,113 claims · 0.1%

Your Cost: $4.15/claim|Median: $72.71
0.1× median
99212Normal range

Office/outpatient visit, low complexity

$22K

14K claims · 0.1%

Your Cost: $1.62/claim|Median: $25.06
0.1× median
80053Normal range

Comprehensive metabolic panel

$21K

4,730 claims · 0.1%

Your Cost: $4.38/claim|Median: $7.24
0.6× median
99204Normal range

Office/outpatient visit, new patient, mod-high complexity

$20K

3,487 claims · 0.1%

Your Cost: $5.70/claim|Median: $84.03
0.1× median
99215Normal range

Office/outpatient visit, high complexity

$19K

5,973 claims · 0.1%

Your Cost: $3.25/claim|Median: $74.09
0.0× median
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