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Provider 1396836029

NPI: 1396836029Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$8.7M

$8,693,155

Total Claims

120K

Beneficiaries

108K

1.1 claims/patient

Avg Cost/Claim

$72

Monthly Spending Trend

Yearly Spending

2018
$1.2M
+26%
2019
$1.5M
-22%
2020
$1.2M
-2%
2021
$1.1M
+11%
2022
$1.3M
+12%
2023
$1.4M
-31%
2024
$983K

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 37% of total spending.

99213Top 5%

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

$3.2M

22K claims · 37.2%

Your Cost: $146.65/claim|Median: $37.81
3.9× median
99214Top 5%

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

$2.3M

15K claims · 25.9%

Your Cost: $151.76/claim|Median: $53.41
2.8× median
D1206Top 1%

Topical application of fluoride varnish

$519K

5,816 claims · 6.0%

Your Cost: $89.15/claim|Median: $18.12
4.9× median
99391Top 5%

Preventive medicine, established patient, infant (under 1)

$356K

1,812 claims · 4.1%

Your Cost: $196.22/claim|Median: $69.35
2.8× median
99392Top 5%

Preventive medicine, established patient, age 1-4

$300K

1,533 claims · 3.4%

Your Cost: $195.61/claim|Median: $75.18
2.6× median
D0120Top 1%

Periodic oral evaluation, established patient

$260K

2,533 claims · 3.0%

Your Cost: $102.67/claim|Median: $24.34
4.2× median
90834Top 5%

Psychotherapy, 45 minutes

$250K

1,464 claims · 2.9%

Your Cost: $170.71/claim|Median: $63.65
2.7× median
99393Top 5%

Preventive medicine, established patient, age 5-11

$241K

1,226 claims · 2.8%

Your Cost: $196.36/claim|Median: $74.82
2.6× median
96372Top 5%

Therapeutic injection, subcutaneous/intramuscular

$175K

1,561 claims · 2.0%

Your Cost: $112.11/claim|Median: $9.56
11.7× median
D0140Top 1%

Limited oral evaluation, problem focused

$150K

1,182 claims · 1.7%

Your Cost: $127.32/claim|Median: $27.07
4.7× median
99394Top 5%

Preventive medicine, established patient, age 12-17

$150K

796 claims · 1.7%

Your Cost: $188.21/claim|Median: $80.15
2.3× median
99211Top 1%

Office/outpatient visit, minimal complexity

$134K

778 claims · 1.5%

Your Cost: $171.75/claim|Median: $12.93
13.3× median
D0272Top 1%

Bitewings, two radiographic images

$84K

1,500 claims · 1.0%

Your Cost: $55.69/claim|Median: $15.81
3.5× median
D0150Top 1%

Comprehensive oral evaluation, new or established patient

$79K

661 claims · 0.9%

Your Cost: $119.80/claim|Median: $32.07
3.7× median
D7140Normal range

Extraction, erupted tooth or exposed root

$72K

1,162 claims · 0.8%

Your Cost: $61.94/claim|Median: $57.39
1.1× median
D1351Normal range

Sealant, per tooth

$65K

3,050 claims · 0.8%

Your Cost: $21.46/claim|Median: $26.10
0.8× median
D0274Top 1%

Bitewings, four radiographic images

$60K

1,010 claims · 0.7%

Your Cost: $59.10/claim|Median: $22.54
2.6× median
99212Top 5%

Office/outpatient visit, low complexity

$49K

386 claims · 0.6%

Your Cost: $127.02/claim|Median: $25.06
5.1× median
99204Top 5%

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

$44K

239 claims · 0.5%

Your Cost: $183.71/claim|Median: $84.03
2.2× median
99215Top 25%

Office/outpatient visit, high complexity

$36K

268 claims · 0.4%

Your Cost: $135.54/claim|Median: $74.09
1.8× median
D2391Normal range

Resin-based composite, one surface, posterior

$19K

281 claims · 0.2%

Your Cost: $67.02/claim|Median: $54.60
1.2× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$19K

296 claims · 0.2%

Your Cost: $63.15/claim|Median: $71.00
0.9× median
D1110Normal range

Prophylaxis, adult cleaning

$19K

934 claims · 0.2%

Your Cost: $19.90/claim|Median: $43.38
0.5× median
90471Normal range

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

$18K

5,107 claims · 0.2%

Your Cost: $3.49/claim|Median: $9.80
0.4× median
D9230Normal range

Inhalation of nitrous oxide/analgesia, anxiolysis

$16K

843 claims · 0.2%

Your Cost: $18.67/claim|Median: $26.24
0.7× median
90837Top 10%

Psychotherapy, 60 minutes

$11K

85 claims · 0.1%

Your Cost: $133.25/claim|Median: $85.66
1.6× median
99203Top 5%

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

$11K

74 claims · 0.1%

Your Cost: $146.93/claim|Median: $57.85
2.5× median
S0281Normal range

$10K

112 claims · 0.1%

Your Cost: $91.94/claim|Median: $92.97
1.0× median
90791Top 10%

Psychiatric diagnostic evaluation

$9K

53 claims · 0.1%

Your Cost: $174.58/claim|Median: $99.21
1.8× median
99383Top 5%

Preventive visit, new patient, late childhood (5-11 yr)

$9K

54 claims · 0.1%

Your Cost: $160.77/claim|Median: $81.92
2.0× median
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