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Provider 1790787919

NPI: 1790787919Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$10.4M

$10,372,589

Total Claims

383K

Beneficiaries

232K

1.7 claims/patient

Avg Cost/Claim

$27

Monthly Spending Trend

Yearly Spending

2018
$836K
+45%
2019
$1.2M
+68%
2020
$2.0M
-21%
2021
$1.6M
+17%
2022
$1.9M
-16%
2023
$1.6M
-19%
2024
$1.3M

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 32% of total spending.

99213Normal range

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

$3.3M

99K claims · 32.1%

Your Cost: $33.66/claim|Median: $37.81
0.9× median
99214Normal range

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

$807K

23K claims · 7.8%

Your Cost: $35.16/claim|Median: $53.41
0.7× median
D1110Normal range

Prophylaxis, adult cleaning

$677K

18K claims · 6.5%

Your Cost: $37.91/claim|Median: $43.38
0.9× median
90834Normal range

Psychotherapy, 45 minutes

$415K

6,869 claims · 4.0%

Your Cost: $60.35/claim|Median: $63.65
0.9× median
99395Normal range

Preventive medicine, established patient, age 18-39

$406K

11K claims · 3.9%

Your Cost: $37.80/claim|Median: $72.71
0.5× median
99212Normal range

Office/outpatient visit, low complexity

$335K

12K claims · 3.2%

Your Cost: $28.73/claim|Median: $25.06
1.1× median
D0330Normal range

Panoramic radiographic image

$299K

11K claims · 2.9%

Your Cost: $27.91/claim|Median: $37.36
0.7× median
99393Normal range

Preventive medicine, established patient, age 5-11

$265K

9,499 claims · 2.6%

Your Cost: $27.86/claim|Median: $74.82
0.4× median
90471Normal range

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

$259K

23K claims · 2.5%

Your Cost: $11.12/claim|Median: $9.80
1.1× median
90837Normal range

Psychotherapy, 60 minutes

$244K

3,844 claims · 2.4%

Your Cost: $63.60/claim|Median: $85.66
0.7× median
99394Normal range

Preventive medicine, established patient, age 12-17

$244K

9,030 claims · 2.3%

Your Cost: $26.98/claim|Median: $80.15
0.3× median
99211Top 25%

Office/outpatient visit, minimal complexity

$225K

11K claims · 2.2%

Your Cost: $20.71/claim|Median: $12.93
1.6× median
D2391Normal range

Resin-based composite, one surface, posterior

$215K

3,777 claims · 2.1%

Your Cost: $57.04/claim|Median: $54.60
1.0× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$203K

7,417 claims · 2.0%

Your Cost: $27.40/claim|Median: $32.07
0.9× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$196K

2,870 claims · 1.9%

Your Cost: $68.22/claim|Median: $71.00
1.0× median
99396Normal range

Preventive medicine, established patient, age 40-64

$164K

4,320 claims · 1.6%

Your Cost: $38.04/claim|Median: $76.06
0.5× median
90832Normal range

Psychotherapy, 30 minutes

$160K

3,244 claims · 1.5%

Your Cost: $49.27/claim|Median: $41.28
1.2× median
D0140Normal range

Limited oral evaluation, problem focused

$151K

5,570 claims · 1.5%

Your Cost: $27.09/claim|Median: $27.07
1.0× median
99392Normal range

Preventive medicine, established patient, age 1-4

$149K

7,867 claims · 1.4%

Your Cost: $18.90/claim|Median: $75.18
0.3× median
90791Normal range

Psychiatric diagnostic evaluation

$128K

1,522 claims · 1.2%

Your Cost: $83.99/claim|Median: $99.21
0.8× median
D0120Top 25%

Periodic oral evaluation, established patient

$105K

3,405 claims · 1.0%

Your Cost: $30.90/claim|Median: $24.34
1.3× median
90472Normal range

Immunization administration, each additional vaccine

$96K

8,701 claims · 0.9%

Your Cost: $11.00/claim|Median: $11.79
0.9× median
J1050Normal range

Injection, medroxyprogesterone acetate, one milligram

$96K

2,609 claims · 0.9%

Your Cost: $36.65/claim|Median: $41.92
0.9× median
D0274Normal range

Bitewings, four radiographic images

$81K

3,350 claims · 0.8%

Your Cost: $24.30/claim|Median: $22.54
1.1× median
97110Normal range

Therapeutic exercises, each 15 min

$78K

4,011 claims · 0.8%

Your Cost: $19.49/claim|Median: $24.49
0.8× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$77K

4,079 claims · 0.7%

Your Cost: $18.90/claim|Median: $69.35
0.3× median
G2023Normal range

Specimen collection for COVID-19 testing

$57K

5,819 claims · 0.5%

Your Cost: $9.76/claim|Median: $17.15
0.6× median
99422Top 25%

Online digital E/M, 11-20 min

$52K

1,962 claims · 0.5%

Your Cost: $26.54/claim|Median: $17.90
1.5× median
Q3014Normal range

Telehealth originating site facility fee

$52K

2,628 claims · 0.5%

Your Cost: $19.77/claim|Median: $15.37
1.3× median
99442Normal range

Telephone E/M by physician, 11-20 minutes

$51K

1,514 claims · 0.5%

Your Cost: $33.46/claim|Median: $22.44
1.5× median
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