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Provider 1174820815

NPI: 1174820815Share
Active Billing Period:2018-01→2024-12(83 months)

Total Paid

$11.4M

$11,365,332

Total Claims

331K

Beneficiaries

293K

1.1 claims/patient

Avg Cost/Claim

$34

Monthly Spending Trend

Yearly Spending

2018
$1.1M
+30%
2019
$1.4M
-59%
2020
$565K
+220%
2021
$1.8M
+23%
2022
$2.2M
-1%
2023
$2.2M
-4%
2024
$2.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 33% of total spending.

99214Top 25%

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

$3.8M

46K claims · 33.4%

Your Cost: $83.28/claim|Median: $53.41
1.6× median
99213Top 25%

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

$2.5M

42K claims · 22.2%

Your Cost: $60.42/claim|Median: $37.81
1.6× median
D0150Top 25%

Comprehensive oral evaluation, new or established patient

$539K

9,103 claims · 4.7%

Your Cost: $59.26/claim|Median: $32.07
1.8× median
D0120Top 25%

Periodic oral evaluation, established patient

$370K

9,400 claims · 3.3%

Your Cost: $39.40/claim|Median: $24.34
1.6× median
D1206Normal range

Topical application of fluoride varnish

$357K

21K claims · 3.1%

Your Cost: $16.77/claim|Median: $18.12
0.9× median
D1110Top 25%

Prophylaxis, adult cleaning

$321K

5,453 claims · 2.8%

Your Cost: $58.86/claim|Median: $43.38
1.4× median
D1120Top 25%

Prophylaxis, adult

$288K

6,410 claims · 2.5%

Your Cost: $44.90/claim|Median: $33.86
1.3× median
D0140Top 10%

Limited oral evaluation, problem focused

$275K

5,186 claims · 2.4%

Your Cost: $52.94/claim|Median: $27.07
2.0× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$241K

3,529 claims · 2.1%

Your Cost: $68.34/claim|Median: $71.00
1.0× median
D0210Normal range

Intraoral, complete series of radiographic images

$207K

4,800 claims · 1.8%

Your Cost: $43.11/claim|Median: $46.33
0.9× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$170K

21K claims · 1.5%

Your Cost: $8.10/claim|Median: $7.33
1.1× median
D0220Top 25%

Intraoral periapical radiographic image, first film

$170K

12K claims · 1.5%

Your Cost: $14.11/claim|Median: $10.51
1.3× median
96158Normal range

$148K

4,371 claims · 1.3%

Your Cost: $33.75/claim|Median: $28.43
1.2× median
D1351Normal range

Sealant, per tooth

$140K

6,199 claims · 1.2%

Your Cost: $22.52/claim|Median: $26.10
0.9× median
96156Normal range

$133K

2,930 claims · 1.2%

Your Cost: $45.35/claim|Median: $22.36
2.0× median
99212Top 25%

Office/outpatient visit, low complexity

$124K

2,350 claims · 1.1%

Your Cost: $52.81/claim|Median: $25.06
2.1× median
D0274Normal range

Bitewings, four radiographic images

$118K

5,923 claims · 1.0%

Your Cost: $19.93/claim|Median: $22.54
0.9× median
96150Top 10%

Health behavior assessment, initial

$116K

2,176 claims · 1.0%

Your Cost: $53.53/claim|Median: $17.83
3.0× median
99204Normal range

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

$110K

1,280 claims · 1.0%

Your Cost: $86.15/claim|Median: $84.03
1.0× median
D2391Normal range

Resin-based composite, one surface, posterior

$97K

1,800 claims · 0.9%

Your Cost: $54.01/claim|Median: $54.60
1.0× median
90471Normal range

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$95K

11K claims · 0.8%

Your Cost: $8.89/claim|Median: $9.80
0.9× median
99215Top 25%

Office/outpatient visit, high complexity

$94K

840 claims · 0.8%

Your Cost: $111.42/claim|Median: $74.09
1.5× median
D7140Top 5%

Extraction, erupted tooth or exposed root

$89K

716 claims · 0.8%

Your Cost: $123.75/claim|Median: $57.39
2.2× median
99203Top 25%

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

$88K

954 claims · 0.8%

Your Cost: $91.95/claim|Median: $57.85
1.6× median
90686Top 25%

Influenza virus vaccine, quadrivalent, preservative-free, IM

$84K

4,673 claims · 0.7%

Your Cost: $18.03/claim|Median: $7.18
2.5× median
96152Top 25%

Health behavior intervention, individual

$71K

1,449 claims · 0.6%

Your Cost: $48.83/claim|Median: $20.02
2.4× median
D0330Normal range

Panoramic radiographic image

$61K

2,733 claims · 0.5%

Your Cost: $22.29/claim|Median: $37.36
0.6× median
D0191Normal range

$43K

6,291 claims · 0.4%

Your Cost: $6.82/claim|Median: $11.16
0.6× median
T1015Normal range

Clinic visit/encounter, all-inclusive

$37K

241 claims · 0.3%

Your Cost: $153.78/claim|Median: $121.16
1.3× median
90832Top 10%

Psychotherapy, 30 minutes

$37K

399 claims · 0.3%

Your Cost: $91.55/claim|Median: $41.28
2.2× median
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