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Provider 1205859279

NPI: 1205859279Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$8.0M

$7,950,046

Total Claims

428K

Beneficiaries

325K

1.3 claims/patient

Avg Cost/Claim

$19

Monthly Spending Trend

Yearly Spending

2018
$835K
+54%
2019
$1.3M
-31%
2020
$889K
+28%
2021
$1.1M
+11%
2022
$1.3M
+13%
2023
$1.4M
-22%
2024
$1.1M

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 17% of total spending.

99213Normal range

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

$1.4M

42K claims · 17.2%

Your Cost: $32.45/claim|Median: $37.81
0.9× median
99214Normal range

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

$1.1M

32K claims · 13.7%

Your Cost: $34.50/claim|Median: $53.41
0.6× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$624K

11K claims · 7.8%

Your Cost: $56.16/claim|Median: $69.35
0.8× median
90460Top 25%

Immunization administration, first vaccine/toxoid, with counseling

$623K

16K claims · 7.8%

Your Cost: $39.55/claim|Median: $17.85
2.2× median
99392Normal range

Preventive medicine, established patient, age 1-4

$623K

9,609 claims · 7.8%

Your Cost: $64.82/claim|Median: $75.18
0.9× median
99393Normal range

Preventive medicine, established patient, age 5-11

$369K

5,718 claims · 4.6%

Your Cost: $64.49/claim|Median: $74.82
0.9× median
96110Top 25%

Developmental screening, per standardized instrument

$271K

17K claims · 3.4%

Your Cost: $15.54/claim|Median: $9.10
1.7× median
D1206Normal range

Topical application of fluoride varnish

$230K

13K claims · 2.9%

Your Cost: $18.39/claim|Median: $18.12
1.0× median
D1120Normal range

Prophylaxis, adult

$221K

7,519 claims · 2.8%

Your Cost: $29.36/claim|Median: $33.86
0.9× median
D1110Normal range

Prophylaxis, adult cleaning

$208K

5,514 claims · 2.6%

Your Cost: $37.67/claim|Median: $43.38
0.9× median
99394Normal range

Preventive medicine, established patient, age 12-17

$171K

2,502 claims · 2.1%

Your Cost: $68.30/claim|Median: $80.15
0.9× median
99215Normal range

Office/outpatient visit, high complexity

$148K

2,573 claims · 1.9%

Your Cost: $57.51/claim|Median: $74.09
0.8× median
D0120Normal range

Periodic oral evaluation, established patient

$147K

6,715 claims · 1.8%

Your Cost: $21.85/claim|Median: $24.34
0.9× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$143K

5,768 claims · 1.8%

Your Cost: $24.73/claim|Median: $32.07
0.8× median
H0016Normal range

Alcohol or drug abuse services, prenatal

$126K

735 claims · 1.6%

Your Cost: $170.89/claim|Median: $182.66
0.9× median
90471Normal range

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

$120K

8,883 claims · 1.5%

Your Cost: $13.48/claim|Median: $9.80
1.4× median
D2391Normal range

Resin-based composite, one surface, posterior

$99K

1,846 claims · 1.2%

Your Cost: $53.50/claim|Median: $54.60
1.0× median
99212Normal range

Office/outpatient visit, low complexity

$72K

3,309 claims · 0.9%

Your Cost: $21.80/claim|Median: $25.06
0.9× median
92557Normal range

Comprehensive audiometry, air, bone, and speech testing

$68K

2,175 claims · 0.9%

Your Cost: $31.29/claim|Median: $27.28
1.1× median
D0274Normal range

Bitewings, four radiographic images

$68K

3,103 claims · 0.9%

Your Cost: $21.82/claim|Median: $22.54
1.0× median
90961Normal range

$56K

2,596 claims · 0.7%

Your Cost: $21.63/claim|Median: $47.22
0.5× median
90472Normal range

Immunization administration, each additional vaccine

$54K

3,535 claims · 0.7%

Your Cost: $15.18/claim|Median: $11.79
1.3× median
D7210Normal range

Extraction, erupted tooth, surgical approach

$45K

576 claims · 0.6%

Your Cost: $78.99/claim|Median: $109.42
0.7× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$42K

12K claims · 0.5%

Your Cost: $3.41/claim|Median: $3.67
0.9× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$42K

657 claims · 0.5%

Your Cost: $64.13/claim|Median: $71.00
0.9× median
96161Top 25%

$38K

8,023 claims · 0.5%

Your Cost: $4.71/claim|Median: $2.49
1.9× median
74177Normal range

CT abdomen and pelvis with contrast

$36K

985 claims · 0.5%

Your Cost: $36.51/claim|Median: $65.76
0.6× median
D2740Normal range

Crown, porcelain/ceramic substrate

$32K

64 claims · 0.4%

Your Cost: $504.43/claim|Median: $509.58
1.0× median
90697Top 25%

$32K

1,355 claims · 0.4%

Your Cost: $23.77/claim|Median: $7.24
3.3× median
D7140Normal range

Extraction, erupted tooth or exposed root

$32K

617 claims · 0.4%

Your Cost: $51.93/claim|Median: $57.39
0.9× median
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