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Provider 1396261756

NPI: 1396261756Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$9.7M

$9,667,071

Total Claims

671K

Beneficiaries

393K

1.7 claims/patient

Avg Cost/Claim

$14

Monthly Spending Trend

Yearly Spending

2018
$821K
+51%
2019
$1.2M
+8%
2020
$1.3M
+18%
2021
$1.6M
+11%
2022
$1.7M
+2%
2023
$1.8M
-36%
2024
$1.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 60% of total spending.

T1015Normal range

Clinic visit/encounter, all-inclusive

$5.8M

81K claims · 60.2%

Your Cost: $72.26/claim|Median: $121.16
0.6× median
99213Normal range

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

$1.3M

63K claims · 13.7%

Your Cost: $21.01/claim|Median: $37.81
0.6× median
99214Normal range

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

$287K

9,337 claims · 3.0%

Your Cost: $30.71/claim|Median: $53.41
0.6× median
90832Normal range

Psychotherapy, 30 minutes

$269K

12K claims · 2.8%

Your Cost: $21.82/claim|Median: $41.28
0.5× median
90837Normal range

Psychotherapy, 60 minutes

$160K

4,018 claims · 1.7%

Your Cost: $39.81/claim|Median: $85.66
0.5× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$153K

11K claims · 1.6%

Your Cost: $13.94/claim|Median: $17.85
0.8× median
99392Normal range

Preventive medicine, established patient, age 1-4

$112K

3,431 claims · 1.2%

Your Cost: $32.50/claim|Median: $75.18
0.4× median
D1110Normal range

Prophylaxis, adult cleaning

$104K

7,976 claims · 1.1%

Your Cost: $13.02/claim|Median: $43.38
0.3× median
99393Normal range

Preventive medicine, established patient, age 5-11

$88K

2,950 claims · 0.9%

Your Cost: $29.94/claim|Median: $74.82
0.4× median
D0120Normal range

Periodic oral evaluation, established patient

$86K

12K claims · 0.9%

Your Cost: $7.32/claim|Median: $24.34
0.3× median
99212Normal range

Office/outpatient visit, low complexity

$83K

7,301 claims · 0.9%

Your Cost: $11.32/claim|Median: $25.06
0.5× median
99394Normal range

Preventive medicine, established patient, age 12-17

$82K

2,355 claims · 0.8%

Your Cost: $34.65/claim|Median: $80.15
0.4× median
D1120Normal range

Prophylaxis, adult

$79K

9,093 claims · 0.8%

Your Cost: $8.64/claim|Median: $33.86
0.3× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$76K

2,838 claims · 0.8%

Your Cost: $26.95/claim|Median: $69.35
0.4× median
D2391Normal range

Resin-based composite, one surface, posterior

$64K

2,424 claims · 0.7%

Your Cost: $26.27/claim|Median: $54.60
0.5× median
D1206Normal range

Topical application of fluoride varnish

$64K

9,780 claims · 0.7%

Your Cost: $6.51/claim|Median: $18.12
0.4× median
90834Normal range

Psychotherapy, 45 minutes

$61K

2,181 claims · 0.6%

Your Cost: $27.86/claim|Median: $63.65
0.4× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$60K

6,114 claims · 0.6%

Your Cost: $9.78/claim|Median: $32.07
0.3× median
99395Normal range

Preventive medicine, established patient, age 18-39

$52K

1,644 claims · 0.5%

Your Cost: $31.38/claim|Median: $72.71
0.4× median
G0467Normal range

Federally qualified health center visit, mental health

$50K

2,472 claims · 0.5%

Your Cost: $20.39/claim|Median: $21.91
0.9× median
Q3014Normal range

Telehealth originating site facility fee

$44K

5,589 claims · 0.5%

Your Cost: $7.85/claim|Median: $15.37
0.5× median
D7140Normal range

Extraction, erupted tooth or exposed root

$40K

2,114 claims · 0.4%

Your Cost: $18.69/claim|Median: $57.39
0.3× median
D0274Normal range

Bitewings, four radiographic images

$39K

5,856 claims · 0.4%

Your Cost: $6.61/claim|Median: $22.54
0.3× median
J1050Top 10%

Injection, medroxyprogesterone acetate, one milligram

$37K

424 claims · 0.4%

Your Cost: $86.38/claim|Median: $41.92
2.1× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$36K

1,576 claims · 0.4%

Your Cost: $23.02/claim|Median: $71.00
0.3× median
90670Top 10%

$33K

1,191 claims · 0.3%

Your Cost: $27.84/claim|Median: $5.94
4.7× median
D0140Normal range

Limited oral evaluation, problem focused

$29K

3,632 claims · 0.3%

Your Cost: $7.91/claim|Median: $27.07
0.3× median
D0330Normal range

Panoramic radiographic image

$27K

1,213 claims · 0.3%

Your Cost: $22.14/claim|Median: $37.36
0.6× median
92551Normal range

Screening audiometry, pure tone, air only

$22K

6,580 claims · 0.2%

Your Cost: $3.40/claim|Median: $6.61
0.5× median
99215Normal range

Office/outpatient visit, high complexity

$21K

521 claims · 0.2%

Your Cost: $40.70/claim|Median: $74.09
0.5× median
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