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⚖️ Compare🖨️ Print Report

Unknown Provider 1609865641

NPI: 1609865641SharePrint ReportML Risk: 85%
View on Risk Watchlist →

Total Paid

$136K

$136,188

Total Claims

2,257

Beneficiaries

1,930

1.2 claims/patient

Avg Cost/Claim

$60

🔍 Analysis

Provider Overview

is a Medicaid provider based in Unknown location. From the 2018–2024 period, this provider received $136K in Medicaid payments across 2K claims serving 2K beneficiaries.

↑ 397% growthsince first billing year

Yearly Spending

2020
$23K
+397%
2021
$113K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 7 distinct procedure codes. The top code (D7230 (Extraction, impacted tooth, partial bony)) accounts for 56% of total spending.

D7230Normal range

Extraction, impacted tooth, partial bony

$76K

455 claims · 56.2%

Your Cost: $168.11/claim|Median: $187.09
0.9× median
D0330Top 25%

Panoramic radiographic image

$26K

469 claims · 19.4%

Your Cost: $56.23/claim|Median: $37.36
1.5× median
D9239Normal range

$15K

269 claims · 11.2%

Your Cost: $56.65/claim|Median: $73.67
0.8× median
D0140Normal range

Limited oral evaluation, problem focused

$9K

476 claims · 6.8%

Your Cost: $19.38/claim|Median: $27.07
0.7× median
D7140Normal range

Extraction, erupted tooth or exposed root

$4K

62 claims · 3.0%

Your Cost: $65.51/claim|Median: $57.39
1.1× median
D9222Normal range

Deep sedation/general anesthesia, first 15 minutes

$4K

66 claims · 2.7%

Your Cost: $56.05/claim|Median: $90.28
0.6× median
D0350Normal range

$1K

460 claims · 0.8%

Your Cost: $2.40/claim|Median: $9.73
0.2× median
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