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Provider 1700950235

NPI: 1700950235Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$8.7M

$8,711,223

Total Claims

298K

Beneficiaries

274K

1.1 claims/patient

Avg Cost/Claim

$29

Monthly Spending Trend

Yearly Spending

2018
$1.6M
-6%
2019
$1.5M
-19%
2020
$1.2M
-2%
2021
$1.2M
-3%
2022
$1.1M
-12%
2023
$1.0M
+10%
2024
$1.1M

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 42% of total spending.

G0467Top 25%

Federally qualified health center visit, mental health

$3.7M

72K claims · 42.2%

Your Cost: $51.24/claim|Median: $21.91
2.3× median
D7140Top 25%

Extraction, erupted tooth or exposed root

$674K

7,290 claims · 7.7%

Your Cost: $92.43/claim|Median: $57.39
1.6× median
D0120Top 5%

Periodic oral evaluation, established patient

$462K

5,868 claims · 5.3%

Your Cost: $78.80/claim|Median: $24.34
3.2× median
99213Normal range

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

$437K

36K claims · 5.0%

Your Cost: $12.12/claim|Median: $37.81
0.3× median
D0150Top 5%

Comprehensive oral evaluation, new or established patient

$385K

4,283 claims · 4.4%

Your Cost: $89.87/claim|Median: $32.07
2.8× median
D1110Top 1%

Prophylaxis, adult cleaning

$379K

4,027 claims · 4.3%

Your Cost: $94.01/claim|Median: $43.38
2.2× median
G0466Normal range

$280K

4,536 claims · 3.2%

Your Cost: $61.71/claim|Median: $63.31
1.0× median
G0468Normal range

$272K

4,688 claims · 3.1%

Your Cost: $58.06/claim|Median: $43.74
1.3× median
D0140Top 5%

Limited oral evaluation, problem focused

$262K

2,955 claims · 3.0%

Your Cost: $88.58/claim|Median: $27.07
3.3× median
99214Normal range

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

$220K

14K claims · 2.5%

Your Cost: $16.11/claim|Median: $53.41
0.3× median
D2391Top 5%

Resin-based composite, one surface, posterior

$171K

1,619 claims · 2.0%

Your Cost: $105.42/claim|Median: $54.60
1.9× median
G0470Normal range

Chronic care management services, FQHC/RHC

$167K

3,652 claims · 1.9%

Your Cost: $45.82/claim|Median: $45.95
1.0× median
D2392Top 10%

Resin-based composite, two surfaces, posterior

$135K

1,036 claims · 1.5%

Your Cost: $130.19/claim|Median: $71.00
1.8× median
D0210Normal range

Intraoral, complete series of radiographic images

$105K

3,635 claims · 1.2%

Your Cost: $28.79/claim|Median: $46.33
0.6× median
99212Normal range

Office/outpatient visit, low complexity

$80K

10K claims · 0.9%

Your Cost: $7.64/claim|Median: $25.06
0.3× median
J1050Normal range

Injection, medroxyprogesterone acetate, one milligram

$73K

1,203 claims · 0.8%

Your Cost: $60.55/claim|Median: $41.92
1.4× median
D0274Normal range

Bitewings, four radiographic images

$56K

2,777 claims · 0.6%

Your Cost: $20.01/claim|Median: $22.54
0.9× median
D7210Top 25%

Extraction, erupted tooth, surgical approach

$55K

432 claims · 0.6%

Your Cost: $128.46/claim|Median: $109.42
1.2× median
99392Normal range

Preventive medicine, established patient, age 1-4

$45K

1,780 claims · 0.5%

Your Cost: $25.42/claim|Median: $75.18
0.3× median
90832Normal range

Psychotherapy, 30 minutes

$43K

3,024 claims · 0.5%

Your Cost: $14.32/claim|Median: $41.28
0.3× median
90651Top 10%

HPV vaccine, 9-valent

$41K

796 claims · 0.5%

Your Cost: $51.64/claim|Median: $8.93
5.8× median
V2020Normal range

Frames, purchases

$41K

1,910 claims · 0.5%

Your Cost: $21.21/claim|Median: $19.33
1.1× median
92012Normal range

Ophthalmological exam, intermediate, established patient

$39K

3,471 claims · 0.4%

Your Cost: $11.25/claim|Median: $38.23
0.3× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$36K

4,325 claims · 0.4%

Your Cost: $8.34/claim|Median: $17.85
0.5× median
D1120Normal range

Prophylaxis, adult

$33K

847 claims · 0.4%

Your Cost: $38.82/claim|Median: $33.86
1.1× median
S0621Normal range

$32K

2,466 claims · 0.4%

Your Cost: $13.18/claim|Median: $44.45
0.3× median
99396Normal range

Preventive medicine, established patient, age 40-64

$30K

1,240 claims · 0.3%

Your Cost: $24.40/claim|Median: $76.06
0.3× median
99395Normal range

Preventive medicine, established patient, age 18-39

$30K

1,428 claims · 0.3%

Your Cost: $20.96/claim|Median: $72.71
0.3× median
D0220Normal range

Intraoral periapical radiographic image, first film

$28K

3,705 claims · 0.3%

Your Cost: $7.47/claim|Median: $10.51
0.7× median
59426Normal range

Antepartum care only, high risk, additional visits

$26K

92 claims · 0.3%

Your Cost: $277.60/claim|Median: $122.30
2.3× median
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