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Provider 1215978960

NPI: 1215978960Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$15.0M

$14,998,088

Total Claims

241K

Beneficiaries

136K

1.8 claims/patient

Avg Cost/Claim

$62

Monthly Spending Trend

Yearly Spending

2018
$2.1M
+33%
2019
$2.7M
-12%
2020
$2.4M
+10%
2021
$2.6M
-51%
2022
$1.3M
+69%
2023
$2.2M
-19%
2024
$1.8M

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 54% of total spending.

99213Top 10%

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

$8.1M

96K claims · 53.9%

Your Cost: $84.21/claim|Median: $37.81
2.2× median
99214Top 10%

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

$956K

8,517 claims · 6.4%

Your Cost: $112.24/claim|Median: $53.41
2.1× median
90834Top 10%

Psychotherapy, 45 minutes

$884K

6,587 claims · 5.9%

Your Cost: $134.13/claim|Median: $63.65
2.1× median
99212Top 5%

Office/outpatient visit, low complexity

$608K

5,923 claims · 4.1%

Your Cost: $102.73/claim|Median: $25.06
4.1× median
D1110Normal range

Prophylaxis, adult cleaning

$509K

10K claims · 3.4%

Your Cost: $49.17/claim|Median: $43.38
1.1× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$373K

8,900 claims · 2.5%

Your Cost: $41.90/claim|Median: $69.35
0.6× median
99392Normal range

Preventive medicine, established patient, age 1-4

$370K

10K claims · 2.5%

Your Cost: $36.79/claim|Median: $75.18
0.5× median
92014Top 25%

Ophthalmological exam, comprehensive, established patient

$335K

4,400 claims · 2.2%

Your Cost: $76.22/claim|Median: $47.08
1.6× median
99442Top 5%

Telephone E/M by physician, 11-20 minutes

$326K

2,995 claims · 2.2%

Your Cost: $108.92/claim|Median: $22.44
4.9× median
90832Top 5%

Psychotherapy, 30 minutes

$302K

2,044 claims · 2.0%

Your Cost: $147.58/claim|Median: $41.28
3.6× median
99393Normal range

Preventive medicine, established patient, age 5-11

$280K

8,663 claims · 1.9%

Your Cost: $32.38/claim|Median: $74.82
0.4× median
99394Normal range

Preventive medicine, established patient, age 12-17

$218K

7,089 claims · 1.5%

Your Cost: $30.74/claim|Median: $80.15
0.4× median
D0140Top 5%

Limited oral evaluation, problem focused

$184K

2,766 claims · 1.2%

Your Cost: $66.35/claim|Median: $27.07
2.5× median
G0511Top 5%

RHC/FQHC visit, psychiatric collaborative care model

$172K

1,677 claims · 1.1%

Your Cost: $102.68/claim|Median: $11.35
9.0× median
99396Top 25%

Preventive medicine, established patient, age 40-64

$134K

1,250 claims · 0.9%

Your Cost: $107.51/claim|Median: $76.06
1.4× median
D0120Normal range

Periodic oral evaluation, established patient

$115K

4,117 claims · 0.8%

Your Cost: $27.82/claim|Median: $24.34
1.1× median
92012Top 5%

Ophthalmological exam, intermediate, established patient

$108K

1,306 claims · 0.7%

Your Cost: $83.03/claim|Median: $38.23
2.2× median
99443Top 10%

Telephone E/M by physician, 21-30 min

$106K

927 claims · 0.7%

Your Cost: $114.26/claim|Median: $32.55
3.5× median
82948Top 5%

$77K

3,274 claims · 0.5%

Your Cost: $23.40/claim|Median: $1.78
13.1× median
2022FTop 1%

$72K

1,432 claims · 0.5%

Your Cost: $50.04/claim|Median: $0.07
714.8× median
92551Top 25%

Screening audiometry, pure tone, air only

$68K

5,814 claims · 0.5%

Your Cost: $11.76/claim|Median: $6.61
1.8× median
G0467Top 25%

Federally qualified health center visit, mental health

$60K

973 claims · 0.4%

Your Cost: $61.43/claim|Median: $21.91
2.8× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$57K

1,886 claims · 0.4%

Your Cost: $30.03/claim|Median: $32.07
0.9× median
D0230Top 5%

Intraoral, periapical radiographic image, first film

$50K

2,588 claims · 0.3%

Your Cost: $19.33/claim|Median: $7.33
2.6× median
92004Normal range

Ophthalmological exam, comprehensive, new patient

$49K

580 claims · 0.3%

Your Cost: $84.11/claim|Median: $59.72
1.4× median
92015Normal range

Determination of refractive state

$46K

3,052 claims · 0.3%

Your Cost: $15.05/claim|Median: $10.36
1.5× median
99395Top 25%

Preventive medicine, established patient, age 18-39

$40K

419 claims · 0.3%

Your Cost: $94.70/claim|Median: $72.71
1.3× median
D0210Normal range

Intraoral, complete series of radiographic images

$29K

652 claims · 0.2%

Your Cost: $43.88/claim|Median: $46.33
0.9× median
99441Top 5%

Telephone E/M by physician, 5-10 min

$25K

213 claims · 0.2%

Your Cost: $117.22/claim|Median: $13.30
8.8× median
D0220Normal range

Intraoral periapical radiographic image, first film

$24K

2,598 claims · 0.2%

Your Cost: $9.27/claim|Median: $10.51
0.9× median
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