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Provider 1073689600

NPI: 1073689600Share
Active Billing Period:2018-06→2024-12(72 months)

Total Paid

$16.6M

$16,611,211

Total Claims

179K

Beneficiaries

107K

1.7 claims/patient

Avg Cost/Claim

$93

Monthly Spending Trend

Yearly Spending

2018
$12K
+6125%
2019
$732K
+269%
2020
$2.7M
+18%
2021
$3.2M
+8%
2022
$3.4M
+4%
2023
$3.6M
-17%
2024
$3.0M

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 28% of total spending.

G0467Top 10%

Federally qualified health center visit, mental health

$4.6M

40K claims · 27.6%

Your Cost: $113.36/claim|Median: $21.91
5.2× median
99213Top 5%

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

$3.1M

32K claims · 18.4%

Your Cost: $95.99/claim|Median: $37.81
2.5× median
99214Top 10%

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

$2.8M

24K claims · 16.7%

Your Cost: $115.12/claim|Median: $53.41
2.2× median
90832Top 10%

Psychotherapy, 30 minutes

$1.7M

20K claims · 10.2%

Your Cost: $86.47/claim|Median: $41.28
2.1× median
G2025Top 5%

$1.3M

13K claims · 7.6%

Your Cost: $97.52/claim|Median: $15.63
6.2× median
G0470Top 10%

Chronic care management services, FQHC/RHC

$729K

3,698 claims · 4.4%

Your Cost: $197.09/claim|Median: $45.95
4.3× median
90834Top 25%

Psychotherapy, 45 minutes

$347K

3,439 claims · 2.1%

Your Cost: $101.02/claim|Median: $63.65
1.6× median
D4910Normal range

$347K

5,081 claims · 2.1%

Your Cost: $68.29/claim|Median: $75.56
0.9× median
D0120Top 5%

Periodic oral evaluation, established patient

$327K

4,928 claims · 2.0%

Your Cost: $66.41/claim|Median: $24.34
2.7× median
99395Normal range

Preventive medicine, established patient, age 18-39

$326K

5,418 claims · 2.0%

Your Cost: $60.19/claim|Median: $72.71
0.8× median
D0999Top 25%

Unspecified diagnostic procedure, by report

$235K

1,006 claims · 1.4%

Your Cost: $233.15/claim|Median: $101.33
2.3× median
99212Top 25%

Office/outpatient visit, low complexity

$193K

4,707 claims · 1.2%

Your Cost: $40.99/claim|Median: $25.06
1.6× median
99396Normal range

Preventive medicine, established patient, age 40-64

$162K

2,319 claims · 1.0%

Your Cost: $69.74/claim|Median: $76.06
0.9× median
D4341Top 25%

Periodontal scaling, per quadrant

$144K

1,206 claims · 0.9%

Your Cost: $119.80/claim|Median: $70.00
1.7× median
D1110Top 25%

Prophylaxis, adult cleaning

$117K

1,924 claims · 0.7%

Your Cost: $60.99/claim|Median: $43.38
1.4× median
S0281Normal range

$101K

3,993 claims · 0.6%

Your Cost: $25.31/claim|Median: $92.97
0.3× median
99215Top 25%

Office/outpatient visit, high complexity

$66K

464 claims · 0.4%

Your Cost: $142.41/claim|Median: $74.09
1.9× median
G0468Top 5%

$36K

144 claims · 0.2%

Your Cost: $246.76/claim|Median: $43.74
5.6× median
D0140Top 5%

Limited oral evaluation, problem focused

$28K

300 claims · 0.2%

Your Cost: $92.96/claim|Median: $27.07
3.4× median
D0210Top 10%

Intraoral, complete series of radiographic images

$24K

342 claims · 0.1%

Your Cost: $70.29/claim|Median: $46.33
1.5× median
90791Top 10%

Psychiatric diagnostic evaluation

$12K

68 claims · 0.1%

Your Cost: $179.83/claim|Median: $99.21
1.8× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$9K

220 claims · 0.1%

Your Cost: $40.58/claim|Median: $32.07
1.3× median
D9997Normal range

$8K

167 claims · 0.0%

Your Cost: $49.48/claim|Median: $33.57
1.5× median
D1999Top 1%

$6K

26 claims · 0.0%

Your Cost: $246.76/claim|Median: $11.95
20.6× median
99334Normal range

$6K

772 claims · 0.0%

Your Cost: $8.06/claim|Median: $9.92
0.8× median
11721Normal range

$4K

1,884 claims · 0.0%

Your Cost: $1.88/claim|Median: $8.56
0.2× median
D2392Top 5%

Resin-based composite, two surfaces, posterior

$3K

18 claims · 0.0%

Your Cost: $168.83/claim|Median: $71.00
2.4× median
99203Top 5%

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

$3K

20 claims · 0.0%

Your Cost: $128.17/claim|Median: $57.85
2.2× median
D0220Normal range

Intraoral periapical radiographic image, first film

$2K

262 claims · 0.0%

Your Cost: $6.27/claim|Median: $10.51
0.6× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$934

232 claims · 0.0%

Your Cost: $4.03/claim|Median: $3.67
1.1× median
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