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Provider 1902954449

NPI: 1902954449Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$18.1M

$18,137,789

Total Claims

370K

Beneficiaries

249K

1.5 claims/patient

Avg Cost/Claim

$49

Monthly Spending Trend

Yearly Spending

2018
$2.1M
+4%
2019
$2.2M
-4%
2020
$2.1M
+19%
2021
$2.5M
+48%
2022
$3.8M
-21%
2023
$3.0M
-20%
2024
$2.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 51% of total spending.

T1015Normal range

Clinic visit/encounter, all-inclusive

$9.3M

58K claims · 51.2%

Your Cost: $161.55/claim|Median: $121.16
1.3× median
D9450Normal range

$1.8M

69K claims · 9.9%

Your Cost: $25.93/claim|Median: $21.95
1.2× median
T1040Normal range

Medicaid certified CCBHC services

$1.2M

8,883 claims · 6.6%

Your Cost: $134.29/claim|Median: $130.29
1.0× median
90834Normal range

Psychotherapy, 45 minutes

$662K

8,890 claims · 3.6%

Your Cost: $74.45/claim|Median: $63.65
1.2× median
99395Top 5%

Preventive medicine, established patient, age 18-39

$430K

2,616 claims · 2.4%

Your Cost: $164.39/claim|Median: $72.71
2.3× median
99213Normal range

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

$308K

19K claims · 1.7%

Your Cost: $15.89/claim|Median: $37.81
0.4× median
D0330Normal range

Panoramic radiographic image

$302K

11K claims · 1.7%

Your Cost: $27.32/claim|Median: $37.36
0.7× median
99394Top 5%

Preventive medicine, established patient, age 12-17

$289K

1,773 claims · 1.6%

Your Cost: $162.80/claim|Median: $80.15
2.0× median
99393Top 5%

Preventive medicine, established patient, age 5-11

$280K

1,732 claims · 1.5%

Your Cost: $161.53/claim|Median: $74.82
2.2× median
D1110Normal range

Prophylaxis, adult cleaning

$273K

16K claims · 1.5%

Your Cost: $17.25/claim|Median: $43.38
0.4× median
99392Top 5%

Preventive medicine, established patient, age 1-4

$253K

1,566 claims · 1.4%

Your Cost: $161.28/claim|Median: $75.18
2.1× median
D7210Normal range

Extraction, erupted tooth, surgical approach

$203K

2,449 claims · 1.1%

Your Cost: $82.81/claim|Median: $109.42
0.8× median
G0467Normal range

Federally qualified health center visit, mental health

$191K

6,383 claims · 1.1%

Your Cost: $29.95/claim|Median: $21.91
1.4× median
99396Normal range

Preventive medicine, established patient, age 40-64

$181K

2,155 claims · 1.0%

Your Cost: $83.84/claim|Median: $76.06
1.1× median
D7140Normal range

Extraction, erupted tooth or exposed root

$171K

4,256 claims · 0.9%

Your Cost: $40.16/claim|Median: $57.39
0.7× median
D2391Normal range

Resin-based composite, one surface, posterior

$166K

11K claims · 0.9%

Your Cost: $14.98/claim|Median: $54.60
0.3× median
99391Top 5%

Preventive medicine, established patient, infant (under 1)

$162K

916 claims · 0.9%

Your Cost: $176.56/claim|Median: $69.35
2.5× median
D0140Normal range

Limited oral evaluation, problem focused

$156K

7,421 claims · 0.9%

Your Cost: $21.05/claim|Median: $27.07
0.8× median
D0230Normal range

Intraoral, periapical radiographic image, first film

$146K

30K claims · 0.8%

Your Cost: $4.88/claim|Median: $7.33
0.7× median
90837Top 25%

Psychotherapy, 60 minutes

$131K

1,057 claims · 0.7%

Your Cost: $124.09/claim|Median: $85.66
1.4× median
G0470Normal range

Chronic care management services, FQHC/RHC

$122K

2,286 claims · 0.7%

Your Cost: $53.57/claim|Median: $45.95
1.2× median
D0220Normal range

Intraoral periapical radiographic image, first film

$99K

14K claims · 0.5%

Your Cost: $7.09/claim|Median: $10.51
0.7× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$88K

4,871 claims · 0.5%

Your Cost: $18.04/claim|Median: $71.00
0.3× median
99173Top 10%

$84K

4,535 claims · 0.5%

Your Cost: $18.55/claim|Median: $2.16
8.6× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$82K

7,301 claims · 0.5%

Your Cost: $11.26/claim|Median: $32.07
0.4× median
D4341Normal range

Periodontal scaling, per quadrant

$70K

2,086 claims · 0.4%

Your Cost: $33.64/claim|Median: $70.00
0.5× median
D0274Normal range

Bitewings, four radiographic images

$65K

7,574 claims · 0.4%

Your Cost: $8.60/claim|Median: $22.54
0.4× median
G2023Top 5%

Specimen collection for COVID-19 testing

$65K

1,667 claims · 0.4%

Your Cost: $39.02/claim|Median: $17.15
2.3× median
D0210Normal range

Intraoral, complete series of radiographic images

$60K

2,658 claims · 0.3%

Your Cost: $22.76/claim|Median: $46.33
0.5× median
96110Normal range

Developmental screening, per standardized instrument

$57K

6,371 claims · 0.3%

Your Cost: $8.96/claim|Median: $9.10
1.0× median
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