Total Paid
$107K
$106,724
Total Claims
2,660
Beneficiaries
2,016
1.3 claims/patient
Avg Cost/Claim
$40
🔍 Analysis
Provider Overview
is a Medicaid provider based in Unknown location. From the 2018–2024 period, this provider received $107K in Medicaid payments across 3K claims serving 2K beneficiaries.
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 6 distinct procedure codes. The top code (99212 (Office/outpatient visit, low complexity)) accounts for 59% of total spending.
$63K
1,594 claims
$39.58
$25.06
Office/outpatient visit, low complexity
$63K
1,594 claims · 59.1%
$34K
507 claims
$67.57
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$34K
507 claims · 32.1%
$8K
431 claims
$18.58
$18.12
Topical application of fluoride varnish
$8K
431 claims · 7.5%
$816
79 claims
$10.33
$6.61
Screening audiometry, pure tone, air only
$816
79 claims · 0.8%
$479
12 claims
$39.89
$27.38
Office/outpatient visit, new patient, straightforward
$479
12 claims · 0.4%
$78
37 claims · 0.1%