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Provider 1265591812

NPI: 1265591812Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$11.1M

$11,113,959

Total Claims

263K

Beneficiaries

223K

1.2 claims/patient

Avg Cost/Claim

$42

Monthly Spending Trend

Yearly Spending

2018
$2.8M
-36%
2019
$1.8M
-41%
2020
$1.1M
-23%
2021
$806K
+34%
2022
$1.1M
+69%
2023
$1.8M
-1%
2024
$1.8M

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 37% of total spending.

G0467Top 25%

Federally qualified health center visit, mental health

$4.1M

60K claims · 36.8%

Your Cost: $68.07/claim|Median: $21.91
3.1× median
G0470Normal range

Chronic care management services, FQHC/RHC

$2.1M

29K claims · 18.5%

Your Cost: $71.00/claim|Median: $45.95
1.5× median
D0140Top 1%

Limited oral evaluation, problem focused

$784K

7,411 claims · 7.1%

Your Cost: $105.73/claim|Median: $27.07
3.9× median
D7140Top 10%

Extraction, erupted tooth or exposed root

$592K

5,467 claims · 5.3%

Your Cost: $108.36/claim|Median: $57.39
1.9× median
D1110Top 10%

Prophylaxis, adult cleaning

$493K

5,905 claims · 4.4%

Your Cost: $83.46/claim|Median: $43.38
1.9× median
D0120Top 5%

Periodic oral evaluation, established patient

$364K

4,051 claims · 3.3%

Your Cost: $89.91/claim|Median: $24.34
3.7× median
S0280Top 25%

Medical home program, comprehensive care management

$344K

1,544 claims · 3.1%

Your Cost: $222.65/claim|Median: $48.38
4.6× median
G0466Normal range

$291K

3,813 claims · 2.6%

Your Cost: $76.39/claim|Median: $63.31
1.2× median
D0150Top 5%

Comprehensive oral evaluation, new or established patient

$277K

3,051 claims · 2.5%

Your Cost: $90.87/claim|Median: $32.07
2.8× median
D2391Top 5%

Resin-based composite, one surface, posterior

$248K

2,357 claims · 2.2%

Your Cost: $105.21/claim|Median: $54.60
1.9× median
D2150Top 1%

Amalgam, two surfaces, primary or permanent

$164K

1,216 claims · 1.5%

Your Cost: $134.94/claim|Median: $66.00
2.0× median
G0469Normal range

$142K

1,978 claims · 1.3%

Your Cost: $71.82/claim|Median: $70.42
1.0× median
S0281Normal range

$136K

2,812 claims · 1.2%

Your Cost: $48.20/claim|Median: $92.97
0.5× median
99213Normal range

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

$128K

44K claims · 1.2%

Your Cost: $2.89/claim|Median: $37.81
0.1× median
D2140Top 1%

Amalgam, one surface, primary or permanent

$103K

896 claims · 0.9%

Your Cost: $115.08/claim|Median: $52.77
2.2× median
D2392Top 10%

Resin-based composite, two surfaces, posterior

$100K

787 claims · 0.9%

Your Cost: $126.50/claim|Median: $71.00
1.8× median
D0210Normal range

Intraoral, complete series of radiographic images

$78K

2,786 claims · 0.7%

Your Cost: $28.11/claim|Median: $46.33
0.6× median
D2331Top 10%

Resin-based composite filling, two surfaces, anterior

$78K

658 claims · 0.7%

Your Cost: $118.64/claim|Median: $73.58
1.6× median
D2332Top 25%

$74K

569 claims · 0.7%

Your Cost: $130.74/claim|Median: $87.21
1.5× median
D2160Top 5%

Amalgam filling, three surfaces

$74K

521 claims · 0.7%

Your Cost: $141.58/claim|Median: $78.55
1.8× median
D0220Normal range

Intraoral periapical radiographic image, first film

$62K

9,978 claims · 0.6%

Your Cost: $6.17/claim|Median: $10.51
0.6× median
D2330Top 5%

Resin-based composite filling, one surface, anterior

$61K

583 claims · 0.5%

Your Cost: $104.84/claim|Median: $66.63
1.6× median
D7210Top 25%

Extraction, erupted tooth, surgical approach

$45K

315 claims · 0.4%

Your Cost: $142.18/claim|Median: $109.42
1.3× median
D0274Normal range

Bitewings, four radiographic images

$41K

2,778 claims · 0.4%

Your Cost: $14.85/claim|Median: $22.54
0.7× median
D1120Normal range

Prophylaxis, adult

$38K

1,021 claims · 0.3%

Your Cost: $37.31/claim|Median: $33.86
1.1× median
D1208Top 25%

Topical application of fluoride, excluding varnish

$27K

1,293 claims · 0.2%

Your Cost: $21.14/claim|Median: $14.36
1.5× median
D5110Top 1%

$26K

24 claims · 0.2%

Your Cost: $1,082.97/claim|Median: $472.15
2.3× median
99214Normal range

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

$20K

8,243 claims · 0.2%

Your Cost: $2.39/claim|Median: $53.41
0.0× median
59426Normal range

Antepartum care only, high risk, additional visits

$19K

26 claims · 0.2%

Your Cost: $737.39/claim|Median: $122.30
6.0× median
D2335Top 25%

$16K

119 claims · 0.1%

Your Cost: $138.51/claim|Median: $105.06
1.3× median
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