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Provider 1891953048

NPI: 1891953048Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$8.9M

$8,900,117

Total Claims

108K

Beneficiaries

88K

1.2 claims/patient

Avg Cost/Claim

$82

Monthly Spending Trend

Yearly Spending

2018
$389K
+84%
2019
$714K
+67%
2020
$1.2M
+21%
2021
$1.4M
+64%
2022
$2.4M
-42%
2023
$1.4M
+3%
2024
$1.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (G0470 (Chronic care management services, FQHC/RHC)) accounts for 33% of total spending.

G0470Top 10%

Chronic care management services, FQHC/RHC

$2.9M

15K claims · 32.7%

Your Cost: $189.58/claim|Median: $45.95
4.1× median
T1015Normal range

Clinic visit/encounter, all-inclusive

$2.2M

13K claims · 24.9%

Your Cost: $171.39/claim|Median: $121.16
1.4× median
T1040Normal range

Medicaid certified CCBHC services

$2.2M

16K claims · 24.8%

Your Cost: $138.07/claim|Median: $130.29
1.1× median
D9450Normal range

$402K

14K claims · 4.5%

Your Cost: $28.45/claim|Median: $21.95
1.3× median
90834Top 25%

Psychotherapy, 45 minutes

$393K

4,681 claims · 4.4%

Your Cost: $84.05/claim|Median: $63.65
1.3× median
G0467Normal range

Federally qualified health center visit, mental health

$114K

3,446 claims · 1.3%

Your Cost: $33.14/claim|Median: $21.91
1.5× median
D1110Normal range

Prophylaxis, adult cleaning

$75K

3,924 claims · 0.8%

Your Cost: $19.16/claim|Median: $43.38
0.4× median
90832Normal range

Psychotherapy, 30 minutes

$58K

1,326 claims · 0.6%

Your Cost: $43.42/claim|Median: $41.28
1.1× median
D0140Normal range

Limited oral evaluation, problem focused

$51K

2,164 claims · 0.6%

Your Cost: $23.49/claim|Median: $27.07
0.9× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$46K

1,518 claims · 0.5%

Your Cost: $30.44/claim|Median: $71.00
0.4× median
99395Top 5%

Preventive medicine, established patient, age 18-39

$45K

253 claims · 0.5%

Your Cost: $178.51/claim|Median: $72.71
2.5× median
D2391Normal range

Resin-based composite, one surface, posterior

$42K

2,095 claims · 0.5%

Your Cost: $20.05/claim|Median: $54.60
0.4× median
D0120Normal range

Periodic oral evaluation, established patient

$38K

3,926 claims · 0.4%

Your Cost: $9.71/claim|Median: $24.34
0.4× median
D0210Normal range

Intraoral, complete series of radiographic images

$32K

1,294 claims · 0.4%

Your Cost: $24.90/claim|Median: $46.33
0.5× median
D7140Normal range

Extraction, erupted tooth or exposed root

$27K

588 claims · 0.3%

Your Cost: $46.35/claim|Median: $57.39
0.8× median
D0220Normal range

Intraoral periapical radiographic image, first film

$26K

2,753 claims · 0.3%

Your Cost: $9.46/claim|Median: $10.51
0.9× median
D0274Normal range

Bitewings, four radiographic images

$24K

1,675 claims · 0.3%

Your Cost: $14.35/claim|Median: $22.54
0.6× median
90791Normal range

Psychiatric diagnostic evaluation

$15K

133 claims · 0.2%

Your Cost: $115.68/claim|Median: $99.21
1.2× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$12K

247 claims · 0.1%

Your Cost: $49.75/claim|Median: $84.26
0.6× median
D2330Normal range

Resin-based composite filling, one surface, anterior

$11K

396 claims · 0.1%

Your Cost: $27.47/claim|Median: $66.63
0.4× median
D2751Normal range

Crown, porcelain fused to predominantly base metal

$11K

28 claims · 0.1%

Your Cost: $387.64/claim|Median: $476.00
0.8× median
D2331Normal range

Resin-based composite filling, two surfaces, anterior

$11K

246 claims · 0.1%

Your Cost: $43.33/claim|Median: $73.58
0.6× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$10K

760 claims · 0.1%

Your Cost: $13.54/claim|Median: $32.07
0.4× median
D1206Top 25%

Topical application of fluoride varnish

$10K

395 claims · 0.1%

Your Cost: $25.15/claim|Median: $18.12
1.4× median
G2025Normal range

$10K

422 claims · 0.1%

Your Cost: $22.63/claim|Median: $15.63
1.4× median
D1120Top 10%

Prophylaxis, adult

$7K

138 claims · 0.1%

Your Cost: $50.43/claim|Median: $33.86
1.5× median
D0330Normal range

Panoramic radiographic image

$6K

130 claims · 0.1%

Your Cost: $45.48/claim|Median: $37.36
1.2× median
90688Normal range

$6K

448 claims · 0.1%

Your Cost: $13.14/claim|Median: $9.00
1.5× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$6K

557 claims · 0.1%

Your Cost: $10.52/claim|Median: $7.18
1.5× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$6K

655 claims · 0.1%

Your Cost: $8.67/claim|Median: $7.33
1.2× median
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