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Provider 1790869436

NPI: 1790869436Share
Active Billing Period:2018-01→2024-12(82 months)

Total Paid

$8.4M

$8,377,129

Total Claims

30K

Beneficiaries

22K

1.3 claims/patient

Avg Cost/Claim

$279

Monthly Spending Trend

Yearly Spending

2018
$670K
+6%
2019
$710K
-15%
2020
$604K
+98%
2021
$1.2M
+30%
2022
$1.6M
+21%
2023
$1.9M
-6%
2024
$1.8M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 25 distinct procedure codes. The top code (G0467 (Federally qualified health center visit, mental health)) accounts for 52% of total spending.

G0467Top 1%

Federally qualified health center visit, mental health

$4.3M

8,095 claims · 51.7%

Your Cost: $535.43/claim|Median: $21.91
24.4× median
G0470Top 1%

Chronic care management services, FQHC/RHC

$3.8M

6,693 claims · 45.7%

Your Cost: $572.20/claim|Median: $45.95
12.5× median
D0140Top 1%

Limited oral evaluation, problem focused

$86K

249 claims · 1.0%

Your Cost: $345.70/claim|Median: $27.07
12.8× median
D0120Top 5%

Periodic oral evaluation, established patient

$40K

473 claims · 0.5%

Your Cost: $84.46/claim|Median: $24.34
3.5× median
D1206Normal range

Topical application of fluoride varnish

$18K

1,198 claims · 0.2%

Your Cost: $14.87/claim|Median: $18.12
0.8× median
D1351Normal range

Sealant, per tooth

$15K

984 claims · 0.2%

Your Cost: $15.29/claim|Median: $26.10
0.6× median
G0466Top 5%

$10K

44 claims · 0.1%

Your Cost: $215.93/claim|Median: $63.31
3.4× median
D1120Normal range

Prophylaxis, adult

$9K

260 claims · 0.1%

Your Cost: $36.30/claim|Median: $33.86
1.1× median
D0150Top 5%

Comprehensive oral evaluation, new or established patient

$7K

73 claims · 0.1%

Your Cost: $100.74/claim|Median: $32.07
3.1× median
D1110Top 1%

Prophylaxis, adult cleaning

$7K

25 claims · 0.1%

Your Cost: $281.40/claim|Median: $43.38
6.5× median
90837Normal range

Psychotherapy, 60 minutes

$4K

1,975 claims · 0.0%

Your Cost: $2.11/claim|Median: $85.66
0.0× median
99213Normal range

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

$4K

6,284 claims · 0.0%

Your Cost: $0.61/claim|Median: $37.81
0.0× median
D1208Normal range

Topical application of fluoride, excluding varnish

$3K

209 claims · 0.0%

Your Cost: $16.31/claim|Median: $14.36
1.1× median
D0191Top 25%

$3K

133 claims · 0.0%

Your Cost: $21.52/claim|Median: $11.16
1.9× median
D0274Normal range

Bitewings, four radiographic images

$2K

83 claims · 0.0%

Your Cost: $25.39/claim|Median: $22.54
1.1× median
D0220Normal range

Intraoral periapical radiographic image, first film

$1K

183 claims · 0.0%

Your Cost: $6.37/claim|Median: $10.51
0.6× median
99402Top 25%

$903

12 claims · 0.0%

Your Cost: $75.22/claim|Median: $31.79
2.4× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$890

30 claims · 0.0%

Your Cost: $29.67/claim|Median: $40.11
0.7× median
99214Normal range

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

$792

966 claims · 0.0%

Your Cost: $0.82/claim|Median: $53.41
0.0× median
90832Normal range

Psychotherapy, 30 minutes

$471

281 claims · 0.0%

Your Cost: $1.67/claim|Median: $41.28
0.0× median
90834Normal range

Psychotherapy, 45 minutes

$314

876 claims · 0.0%

Your Cost: $0.36/claim|Median: $63.65
0.0× median
99392Normal range

Preventive medicine, established patient, age 1-4

$0

74 claims · 0.0%

Your Cost: $0.00/claim|Median: $75.18
D1330Normal range

$0

39 claims · 0.0%

Your Cost: $0.00/claim|Median: $5.73
99212Normal range

Office/outpatient visit, low complexity

$0

209 claims · 0.0%

Your Cost: $0.00/claim|Median: $25.06
D1310Normal range

Nutritional counseling for control of dental disease

$0

588 claims · 0.0%

Your Cost: $0.00/claim|Median: $40.52
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