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Provider 1720152275

NPI: 1720152275Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$10.3M

$10,277,882

Total Claims

358K

Beneficiaries

308K

1.2 claims/patient

Avg Cost/Claim

$29

Monthly Spending Trend

Yearly Spending

2018
$1.5M
+1%
2019
$1.5M
-14%
2020
$1.3M
+11%
2021
$1.4M
+8%
2022
$1.5M
+7%
2023
$1.6M
-9%
2024
$1.5M

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 58% of total spending.

G0467Top 25%

Federally qualified health center visit, mental health

$5.9M

110K claims · 57.8%

Your Cost: $53.77/claim|Median: $21.91
2.5× median
99213Normal range

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

$894K

76K claims · 8.7%

Your Cost: $11.80/claim|Median: $37.81
0.3× median
G0466Normal range

$396K

5,827 claims · 3.8%

Your Cost: $67.90/claim|Median: $63.31
1.1× median
D7140Top 25%

Extraction, erupted tooth or exposed root

$390K

4,101 claims · 3.8%

Your Cost: $95.02/claim|Median: $57.39
1.7× median
D0120Top 1%

Periodic oral evaluation, established patient

$369K

3,226 claims · 3.6%

Your Cost: $114.40/claim|Median: $24.34
4.7× median
D1110Top 1%

Prophylaxis, adult cleaning

$344K

2,921 claims · 3.3%

Your Cost: $117.60/claim|Median: $43.38
2.7× median
G0468Normal range

$249K

4,216 claims · 2.4%

Your Cost: $59.14/claim|Median: $43.74
1.4× median
G0470Normal range

Chronic care management services, FQHC/RHC

$246K

4,422 claims · 2.4%

Your Cost: $55.70/claim|Median: $45.95
1.2× median
D0150Top 1%

Comprehensive oral evaluation, new or established patient

$228K

2,129 claims · 2.2%

Your Cost: $107.25/claim|Median: $32.07
3.3× median
D0140Top 1%

Limited oral evaluation, problem focused

$206K

1,982 claims · 2.0%

Your Cost: $103.83/claim|Median: $27.07
3.8× median
99212Normal range

Office/outpatient visit, low complexity

$163K

23K claims · 1.6%

Your Cost: $7.16/claim|Median: $25.06
0.3× median
99214Normal range

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

$121K

6,985 claims · 1.2%

Your Cost: $17.36/claim|Median: $53.41
0.3× median
D2391Top 1%

Resin-based composite, one surface, posterior

$101K

667 claims · 1.0%

Your Cost: $151.89/claim|Median: $54.60
2.8× median
D2392Top 5%

Resin-based composite, two surfaces, posterior

$82K

514 claims · 0.8%

Your Cost: $160.32/claim|Median: $71.00
2.3× median
J1050Normal range

Injection, medroxyprogesterone acetate, one milligram

$81K

1,366 claims · 0.8%

Your Cost: $59.41/claim|Median: $41.92
1.4× median
D0210Normal range

Intraoral, complete series of radiographic images

$47K

2,110 claims · 0.5%

Your Cost: $22.06/claim|Median: $46.33
0.5× median
99203Normal range

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

$36K

3,060 claims · 0.4%

Your Cost: $11.77/claim|Median: $57.85
0.2× median
90832Normal range

Psychotherapy, 30 minutes

$33K

3,793 claims · 0.3%

Your Cost: $8.82/claim|Median: $41.28
0.2× median
99396Normal range

Preventive medicine, established patient, age 40-64

$33K

1,560 claims · 0.3%

Your Cost: $21.24/claim|Median: $76.06
0.3× median
99395Normal range

Preventive medicine, established patient, age 18-39

$32K

1,795 claims · 0.3%

Your Cost: $17.56/claim|Median: $72.71
0.2× median
90651Top 25%

HPV vaccine, 9-valent

$23K

546 claims · 0.2%

Your Cost: $43.02/claim|Median: $8.93
4.8× median
99392Normal range

Preventive medicine, established patient, age 1-4

$23K

950 claims · 0.2%

Your Cost: $24.70/claim|Median: $75.18
0.3× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$23K

3,617 claims · 0.2%

Your Cost: $6.41/claim|Median: $17.85
0.4× median
99393Normal range

Preventive medicine, established patient, age 5-11

$17K

855 claims · 0.2%

Your Cost: $19.70/claim|Median: $74.82
0.3× median
D0274Normal range

Bitewings, four radiographic images

$17K

1,332 claims · 0.2%

Your Cost: $12.51/claim|Median: $22.54
0.6× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$13K

693 claims · 0.1%

Your Cost: $18.69/claim|Median: $69.35
0.3× median
99204Normal range

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

$13K

805 claims · 0.1%

Your Cost: $16.06/claim|Median: $84.03
0.2× median
99394Normal range

Preventive medicine, established patient, age 12-17

$12K

605 claims · 0.1%

Your Cost: $19.47/claim|Median: $80.15
0.2× median
D0220Normal range

Intraoral periapical radiographic image, first film

$12K

2,638 claims · 0.1%

Your Cost: $4.38/claim|Median: $10.51
0.4× median
G2025Normal range

$10K

3,885 claims · 0.1%

Your Cost: $2.66/claim|Median: $15.63
0.2× median
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