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Provider 1326090390

NPI: 1326090390Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$11.3M

$11,293,709

Total Claims

740K

Beneficiaries

691K

1.1 claims/patient

Avg Cost/Claim

$15

Monthly Spending Trend

Yearly Spending

2018
$80K
+143%
2019
$193K
+572%
2020
$1.3M
-55%
2021
$585K
+267%
2022
$2.1M
+110%
2023
$4.5M
-45%
2024
$2.5M

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 14% of total spending.

99213Normal range

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

$1.6M

70K claims · 14.2%

Your Cost: $22.74/claim|Median: $37.81
0.6× median
99392Normal range

Preventive medicine, established patient, age 1-4

$1.3M

26K claims · 11.4%

Your Cost: $50.15/claim|Median: $75.18
0.7× median
H1000Normal range

Prenatal care, at-risk assessment

$1.2M

17K claims · 10.3%

Your Cost: $70.07/claim|Median: $50.36
1.4× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$1.1M

24K claims · 10.0%

Your Cost: $47.73/claim|Median: $69.35
0.7× median
99393Normal range

Preventive medicine, established patient, age 5-11

$638K

12K claims · 5.7%

Your Cost: $53.30/claim|Median: $74.82
0.7× median
D0190Top 5%

$573K

14K claims · 5.1%

Your Cost: $39.93/claim|Median: $12.78
3.1× median
99394Normal range

Preventive medicine, established patient, age 12-17

$401K

7,351 claims · 3.5%

Your Cost: $54.50/claim|Median: $80.15
0.7× median
D2391Normal range

Resin-based composite, one surface, posterior

$387K

7,710 claims · 3.4%

Your Cost: $50.14/claim|Median: $54.60
0.9× median
D1120Top 10%

Prophylaxis, adult

$373K

7,629 claims · 3.3%

Your Cost: $48.90/claim|Median: $33.86
1.4× median
59410Normal range

$371K

1,185 claims · 3.3%

Your Cost: $313.35/claim|Median: $781.64
0.4× median
D1110Top 25%

Prophylaxis, adult cleaning

$371K

5,641 claims · 3.3%

Your Cost: $65.70/claim|Median: $43.38
1.5× median
D0120Top 25%

Periodic oral evaluation, established patient

$369K

12K claims · 3.3%

Your Cost: $30.06/claim|Median: $24.34
1.2× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$282K

4,047 claims · 2.5%

Your Cost: $69.66/claim|Median: $71.00
1.0× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$265K

6,876 claims · 2.3%

Your Cost: $38.56/claim|Median: $32.07
1.2× median
90471Normal range

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

$243K

56K claims · 2.2%

Your Cost: $4.37/claim|Median: $9.80
0.4× median
99212Normal range

Office/outpatient visit, low complexity

$230K

12K claims · 2.0%

Your Cost: $19.27/claim|Median: $25.06
0.8× median
90472Normal range

Immunization administration, each additional vaccine

$189K

31K claims · 1.7%

Your Cost: $6.05/claim|Median: $11.79
0.5× median
D1351Normal range

Sealant, per tooth

$140K

6,067 claims · 1.2%

Your Cost: $23.07/claim|Median: $26.10
0.9× median
D0274Normal range

Bitewings, four radiographic images

$133K

6,230 claims · 1.2%

Your Cost: $21.27/claim|Median: $22.54
0.9× median
D1206Normal range

Topical application of fluoride varnish

$131K

28K claims · 1.2%

Your Cost: $4.66/claim|Median: $18.12
0.3× median
59515Normal range

$119K

311 claims · 1.1%

Your Cost: $381.79/claim|Median: $786.24
0.5× median
99214Normal range

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

$105K

4,013 claims · 0.9%

Your Cost: $26.27/claim|Median: $53.41
0.5× median
99203Normal range

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

$89K

1,602 claims · 0.8%

Your Cost: $55.82/claim|Median: $57.85
1.0× median
90670Normal range

$87K

9,939 claims · 0.8%

Your Cost: $8.78/claim|Median: $5.94
1.5× median
90671Normal range

$45K

3,652 claims · 0.4%

Your Cost: $12.43/claim|Median: $8.59
1.4× median
99385Normal range

Preventive visit, new patient, 18-39 yr

$44K

920 claims · 0.4%

Your Cost: $47.96/claim|Median: $76.22
0.6× median
D7140Normal range

Extraction, erupted tooth or exposed root

$40K

841 claims · 0.4%

Your Cost: $48.06/claim|Median: $57.39
0.8× median
99396Normal range

Preventive medicine, established patient, age 40-64

$40K

710 claims · 0.4%

Your Cost: $56.90/claim|Median: $76.06
0.7× median
99381Normal range

Preventive visit, new patient, infant (<1 yr)

$39K

849 claims · 0.3%

Your Cost: $46.13/claim|Median: $73.46
0.6× median
99395Normal range

Preventive medicine, established patient, age 18-39

$32K

599 claims · 0.3%

Your Cost: $53.62/claim|Median: $72.71
0.7× median
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