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Provider 1043663107

NPI: 1043663107Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$14.0M

$13,953,000

Total Claims

171K

Beneficiaries

86K

2.0 claims/patient

Avg Cost/Claim

$82

Monthly Spending Trend

Yearly Spending

2018
$28K
+2665%
2019
$767K
+215%
2020
$2.4M
+38%
2021
$3.3M
-23%
2022
$2.6M
-4%
2023
$2.5M
-6%
2024
$2.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 20% of total spending.

99213Top 5%

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

$2.8M

23K claims · 20.0%

Your Cost: $119.20/claim|Median: $37.81
3.2× median
G0467Top 25%

Federally qualified health center visit, mental health

$2.3M

45K claims · 16.4%

Your Cost: $51.27/claim|Median: $21.91
2.3× median
99214Top 5%

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

$2.1M

16K claims · 15.0%

Your Cost: $128.90/claim|Median: $53.41
2.4× median
G2025Top 10%

$1.9M

27K claims · 14.0%

Your Cost: $73.09/claim|Median: $15.63
4.7× median
90832Top 5%

Psychotherapy, 30 minutes

$1.7M

12K claims · 12.1%

Your Cost: $143.61/claim|Median: $41.28
3.5× median
99212Top 10%

Office/outpatient visit, low complexity

$569K

7,919 claims · 4.1%

Your Cost: $71.91/claim|Median: $25.06
2.9× median
G0470Normal range

Chronic care management services, FQHC/RHC

$363K

7,998 claims · 2.6%

Your Cost: $45.41/claim|Median: $45.95
1.0× median
D1110Top 10%

Prophylaxis, adult cleaning

$355K

4,434 claims · 2.5%

Your Cost: $80.03/claim|Median: $43.38
1.8× median
D4910Top 5%

$335K

3,017 claims · 2.4%

Your Cost: $111.08/claim|Median: $75.56
1.5× median
D0120Top 5%

Periodic oral evaluation, established patient

$273K

2,804 claims · 2.0%

Your Cost: $97.19/claim|Median: $24.34
4.0× median
99396Top 25%

Preventive medicine, established patient, age 40-64

$246K

2,217 claims · 1.8%

Your Cost: $111.18/claim|Median: $76.06
1.5× median
D9997Top 10%

$179K

2,103 claims · 1.3%

Your Cost: $85.13/claim|Median: $33.57
2.5× median
99401Top 25%

$153K

5,076 claims · 1.1%

Your Cost: $30.17/claim|Median: $16.53
1.8× median
99395Top 10%

Preventive medicine, established patient, age 18-39

$106K

905 claims · 0.8%

Your Cost: $117.31/claim|Median: $72.71
1.6× median
D0330Top 5%

Panoramic radiographic image

$96K

1,300 claims · 0.7%

Your Cost: $73.75/claim|Median: $37.36
2.0× median
96127Top 5%

Brief emotional/behavioral assessment, per standardized instrument

$92K

3,774 claims · 0.7%

Your Cost: $24.46/claim|Median: $3.67
6.7× median
D0274Top 5%

Bitewings, four radiographic images

$64K

1,261 claims · 0.5%

Your Cost: $50.54/claim|Median: $22.54
2.2× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$55K

1,303 claims · 0.4%

Your Cost: $42.54/claim|Median: $32.07
1.3× median
D0140Top 5%

Limited oral evaluation, problem focused

$47K

545 claims · 0.3%

Your Cost: $85.89/claim|Median: $27.07
3.2× median
G0511Top 1%

RHC/FQHC visit, psychiatric collaborative care model

$45K

211 claims · 0.3%

Your Cost: $215.51/claim|Median: $11.35
19.0× median
90792Top 25%

Psychiatric diagnostic evaluation with medical services

$37K

222 claims · 0.3%

Your Cost: $166.91/claim|Median: $108.91
1.5× median
90834Top 5%

Psychotherapy, 45 minutes

$29K

132 claims · 0.2%

Your Cost: $216.48/claim|Median: $63.65
3.4× median
D1999Top 1%

$22K

231 claims · 0.2%

Your Cost: $94.80/claim|Median: $11.95
7.9× median
90791Top 25%

Psychiatric diagnostic evaluation

$9K

66 claims · 0.1%

Your Cost: $139.11/claim|Median: $99.21
1.4× median
92550Top 25%

$8K

271 claims · 0.1%

Your Cost: $29.88/claim|Median: $14.15
2.1× median
D0210Top 5%

Intraoral, complete series of radiographic images

$8K

76 claims · 0.1%

Your Cost: $104.95/claim|Median: $46.33
2.3× median
D1330Top 1%

$8K

118 claims · 0.1%

Your Cost: $66.27/claim|Median: $5.73
11.6× median
D0170Top 1%

$6K

37 claims · 0.0%

Your Cost: $173.93/claim|Median: $24.39
7.1× median
D9110Top 1%

$6K

54 claims · 0.0%

Your Cost: $105.01/claim|Median: $38.08
2.8× median
92004Top 5%

Ophthalmological exam, comprehensive, new patient

$5K

36 claims · 0.0%

Your Cost: $150.94/claim|Median: $59.72
2.5× median
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