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COUNTY OF WAKE

Clinic/Center, Public Health, State or Local·RALEIGH, NC·NPI: 1801957576Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$27.1M

$27,052,422

Total Claims

3.1M

Beneficiaries

2.7M

1.1 claims/patient

Avg Cost/Claim

$9

Monthly Spending Trend

Yearly Spending

2018
$2.6M
-5%
2019
$2.5M
-39%
2020
$1.5M
+144%
2021
$3.7M
+49%
2022
$5.5M
+1%
2023
$5.5M
+4%
2024
$5.8M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99199 (Unlisted special service, procedure, or report)) accounts for 50% of total spending.

99199Normal range

Unlisted special service, procedure, or report

$13.6M

2.6M claims · 50.2%

Your Cost: $5.26/claim|Median: $5.39
1.0× median
99213Top 10%

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

$1.6M

20K claims · 5.8%

Your Cost: $79.11/claim|Median: $37.81
2.1× median
99214Top 5%

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

$1.2M

9,495 claims · 4.3%

Your Cost: $123.42/claim|Median: $53.41
2.3× median
99502Normal range

$774K

13K claims · 2.9%

Your Cost: $57.88/claim|Median: $59.00
1.0× median
90471Normal range

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

$692K

51K claims · 2.6%

Your Cost: $13.69/claim|Median: $9.80
1.4× median
90472Top 25%

Immunization administration, each additional vaccine

$678K

26K claims · 2.5%

Your Cost: $25.90/claim|Median: $11.79
2.2× median
99391Top 25%

Preventive medicine, established patient, infant (under 1)

$647K

7,074 claims · 2.4%

Your Cost: $91.48/claim|Median: $69.35
1.3× median
99392Normal range

Preventive medicine, established patient, age 1-4

$529K

6,184 claims · 2.0%

Your Cost: $85.58/claim|Median: $75.18
1.1× median
99393Top 25%

Preventive medicine, established patient, age 5-11

$472K

5,005 claims · 1.7%

Your Cost: $94.37/claim|Median: $74.82
1.3× median
D0120Top 25%

Periodic oral evaluation, established patient

$464K

16K claims · 1.7%

Your Cost: $29.86/claim|Median: $24.34
1.2× median
99501Normal range

$447K

8,355 claims · 1.7%

Your Cost: $53.44/claim|Median: $76.03
0.7× median
D2391Top 25%

Resin-based composite, one surface, posterior

$434K

5,096 claims · 1.6%

Your Cost: $85.15/claim|Median: $54.60
1.6× median
D1120Normal range

Prophylaxis, adult

$386K

12K claims · 1.4%

Your Cost: $31.08/claim|Median: $33.86
0.9× median
S0280Normal range

Medical home program, comprehensive care management

$364K

7,615 claims · 1.3%

Your Cost: $47.85/claim|Median: $48.38
1.0× median
T1001Normal range

Nursing assessment/evaluation, per visit

$307K

4,516 claims · 1.1%

Your Cost: $68.06/claim|Median: $49.05
1.4× median
D2392Top 25%

Resin-based composite, two surfaces, posterior

$286K

2,561 claims · 1.1%

Your Cost: $111.83/claim|Median: $71.00
1.6× median
D1206Normal range

Topical application of fluoride varnish

$259K

14K claims · 1.0%

Your Cost: $17.99/claim|Median: $18.12
1.0× median
D1351Normal range

Sealant, per tooth

$240K

7,689 claims · 0.9%

Your Cost: $31.27/claim|Median: $26.10
1.2× median
99395Top 10%

Preventive medicine, established patient, age 18-39

$219K

1,730 claims · 0.8%

Your Cost: $126.71/claim|Median: $72.71
1.7× median
D1110Normal range

Prophylaxis, adult cleaning

$209K

4,696 claims · 0.8%

Your Cost: $44.41/claim|Median: $43.38
1.0× median
99211Top 25%

Office/outpatient visit, minimal complexity

$176K

5,567 claims · 0.6%

Your Cost: $31.54/claim|Median: $12.93
2.4× median
96110Normal range

Developmental screening, per standardized instrument

$163K

17K claims · 0.6%

Your Cost: $9.47/claim|Median: $9.10
1.0× median
76805Top 25%

Ultrasound, pregnant uterus, complete, single fetus

$153K

1,348 claims · 0.6%

Your Cost: $113.68/claim|Median: $74.78
1.5× median
99204Top 5%

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

$153K

788 claims · 0.6%

Your Cost: $194.11/claim|Median: $84.03
2.3× median
S0281Normal range

$148K

1,088 claims · 0.5%

Your Cost: $136.15/claim|Median: $92.97
1.5× median
59426Normal range

Antepartum care only, high risk, additional visits

$142K

224 claims · 0.5%

Your Cost: $632.87/claim|Median: $122.30
5.2× median
59430Normal range

$130K

1,088 claims · 0.5%

Your Cost: $119.59/claim|Median: $80.32
1.5× median
D0150Top 25%

Comprehensive oral evaluation, new or established patient

$127K

2,626 claims · 0.5%

Your Cost: $48.39/claim|Median: $32.07
1.5× median
D0272Top 25%

Bitewings, two radiographic images

$121K

5,812 claims · 0.4%

Your Cost: $20.84/claim|Median: $15.81
1.3× median
D1208Normal range

Topical application of fluoride, excluding varnish

$119K

7,293 claims · 0.4%

Your Cost: $16.38/claim|Median: $14.36
1.1× median
D0220Top 5%

Intraoral periapical radiographic image, first film

$102K

5,745 claims · 0.4%

Your Cost: $17.82/claim|Median: $10.51
1.7× median
99394Normal range

Preventive medicine, established patient, age 12-17

$98K

1,091 claims · 0.4%

Your Cost: $89.94/claim|Median: $80.15
1.1× median
92551Normal range

Screening audiometry, pure tone, air only

$95K

12K claims · 0.4%

Your Cost: $7.68/claim|Median: $6.61
1.2× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$89K

3,008 claims · 0.3%

Your Cost: $29.47/claim|Median: $57.30
0.5× median
D0230Top 10%

Intraoral, periapical radiographic image, first film

$86K

6,539 claims · 0.3%

Your Cost: $13.18/claim|Median: $7.33
1.8× median
D0274Top 10%

Bitewings, four radiographic images

$85K

2,457 claims · 0.3%

Your Cost: $34.67/claim|Median: $22.54
1.5× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$80K

16K claims · 0.3%

Your Cost: $4.87/claim|Median: $3.67
1.3× median
81025Top 25%

Urine pregnancy test

$79K

10K claims · 0.3%

Your Cost: $7.55/claim|Median: $4.81
1.6× median
36415Normal range

Collection of venous blood by venipuncture

$73K

29K claims · 0.3%

Your Cost: $2.48/claim|Median: $1.57
1.6× median
90651Top 25%

HPV vaccine, 9-valent

$72K

2,679 claims · 0.3%

Your Cost: $26.87/claim|Median: $8.93
3.0× median
85018Top 25%

$60K

21K claims · 0.2%

Your Cost: $2.83/claim|Median: $1.71
1.7× median
99212Top 25%

Office/outpatient visit, low complexity

$57K

1,218 claims · 0.2%

Your Cost: $46.91/claim|Median: $25.06
1.9× median
90715Normal range

Tdap vaccine

$57K

4,045 claims · 0.2%

Your Cost: $14.06/claim|Median: $10.32
1.4× median
D2930Top 25%

Prefabricated stainless steel crown, primary tooth

$52K

321 claims · 0.2%

Your Cost: $161.96/claim|Median: $120.85
1.3× median
99381Normal range

Preventive visit, new patient, infant (<1 yr)

$46K

515 claims · 0.2%

Your Cost: $89.76/claim|Median: $73.46
1.2× median
90480Top 10%

$45K

1,006 claims · 0.2%

Your Cost: $45.17/claim|Median: $25.29
1.8× median
90716Top 10%

$45K

1,881 claims · 0.2%

Your Cost: $23.95/claim|Median: $6.18
3.9× median
90739Top 25%

$37K

297 claims · 0.1%

Your Cost: $125.23/claim|Median: $74.43
1.7× median
99215Top 25%

Office/outpatient visit, high complexity

$36K

291 claims · 0.1%

Your Cost: $124.78/claim|Median: $74.09
1.7× median
90474Top 25%

$33K

2,265 claims · 0.1%

Your Cost: $14.67/claim|Median: $8.42
1.7× median

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