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Provider 1972530277

NPI: 1972530277Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$9.1M

$9,069,092

Total Claims

262K

Beneficiaries

232K

1.1 claims/patient

Avg Cost/Claim

$35

Monthly Spending Trend

Yearly Spending

2018
$1.4M
+9%
2019
$1.5M
-23%
2020
$1.2M
+21%
2021
$1.4M
-3%
2022
$1.4M
-5%
2023
$1.3M
-34%
2024
$868K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (G0467 (Federally qualified health center visit, mental health)) accounts for 49% of total spending.

G0467Top 10%

Federally qualified health center visit, mental health

$4.5M

62K claims · 49.2%

Your Cost: $71.81/claim|Median: $21.91
3.3× median
G0470Normal range

Chronic care management services, FQHC/RHC

$965K

15K claims · 10.6%

Your Cost: $66.22/claim|Median: $45.95
1.4× median
D7140Top 25%

Extraction, erupted tooth or exposed root

$519K

6,086 claims · 5.7%

Your Cost: $85.26/claim|Median: $57.39
1.5× median
D0150Top 5%

Comprehensive oral evaluation, new or established patient

$425K

4,510 claims · 4.7%

Your Cost: $94.17/claim|Median: $32.07
2.9× median
D0140Top 5%

Limited oral evaluation, problem focused

$407K

4,143 claims · 4.5%

Your Cost: $98.24/claim|Median: $27.07
3.6× median
D1110Top 1%

Prophylaxis, adult cleaning

$385K

4,268 claims · 4.2%

Your Cost: $90.13/claim|Median: $43.38
2.1× median
G0466Normal range

$373K

4,692 claims · 4.1%

Your Cost: $79.49/claim|Median: $63.31
1.3× median
D0120Top 10%

Periodic oral evaluation, established patient

$259K

5,032 claims · 2.9%

Your Cost: $51.53/claim|Median: $24.34
2.1× median
G0468Normal range

$201K

2,895 claims · 2.2%

Your Cost: $69.34/claim|Median: $43.74
1.6× median
D2392Top 10%

Resin-based composite, two surfaces, posterior

$105K

845 claims · 1.2%

Your Cost: $124.59/claim|Median: $71.00
1.8× median
D2150Top 5%

Amalgam, two surfaces, primary or permanent

$105K

1,022 claims · 1.2%

Your Cost: $102.85/claim|Median: $66.00
1.6× median
D0210Normal range

Intraoral, complete series of radiographic images

$103K

3,877 claims · 1.1%

Your Cost: $26.45/claim|Median: $46.33
0.6× median
D1120Top 25%

Prophylaxis, adult

$100K

2,470 claims · 1.1%

Your Cost: $40.32/claim|Median: $33.86
1.2× median
99213Normal range

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

$75K

35K claims · 0.8%

Your Cost: $2.12/claim|Median: $37.81
0.1× median
D7210Normal range

Extraction, erupted tooth, surgical approach

$72K

630 claims · 0.8%

Your Cost: $113.82/claim|Median: $109.42
1.0× median
D1206Top 25%

Topical application of fluoride varnish

$64K

2,561 claims · 0.7%

Your Cost: $25.01/claim|Median: $18.12
1.4× median
D2391Top 10%

Resin-based composite, one surface, posterior

$38K

386 claims · 0.4%

Your Cost: $98.84/claim|Median: $54.60
1.8× median
D0274Normal range

Bitewings, four radiographic images

$37K

2,306 claims · 0.4%

Your Cost: $16.05/claim|Median: $22.54
0.7× median
99214Normal range

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

$28K

10K claims · 0.3%

Your Cost: $2.75/claim|Median: $53.41
0.1× median
J1050Normal range

Injection, medroxyprogesterone acetate, one milligram

$25K

439 claims · 0.3%

Your Cost: $56.84/claim|Median: $41.92
1.4× median
D4355Top 5%

$23K

186 claims · 0.3%

Your Cost: $123.84/claim|Median: $64.42
1.9× median
D0220Normal range

Intraoral periapical radiographic image, first film

$22K

3,666 claims · 0.2%

Your Cost: $6.04/claim|Median: $10.51
0.6× median
D2140Top 5%

Amalgam, one surface, primary or permanent

$22K

278 claims · 0.2%

Your Cost: $79.27/claim|Median: $52.77
1.5× median
0012ANormal range

COVID-19 vaccine admin, Moderna, 2nd dose

$20K

710 claims · 0.2%

Your Cost: $28.39/claim|Median: $33.85
0.8× median
90834Normal range

Psychotherapy, 45 minutes

$20K

6,490 claims · 0.2%

Your Cost: $3.02/claim|Median: $63.65
0.0× median
0011ANormal range

COVID-19 vaccine admin, Moderna, 1st dose

$16K

773 claims · 0.2%

Your Cost: $21.09/claim|Median: $25.93
0.8× median
99000Top 25%

$15K

1,456 claims · 0.2%

Your Cost: $10.27/claim|Median: $2.30
4.5× median
99392Normal range

Preventive medicine, established patient, age 1-4

$13K

2,484 claims · 0.1%

Your Cost: $5.21/claim|Median: $75.18
0.1× median
D2160Top 10%

Amalgam filling, three surfaces

$12K

106 claims · 0.1%

Your Cost: $113.95/claim|Median: $78.55
1.5× median
D0272Top 25%

Bitewings, two radiographic images

$11K

523 claims · 0.1%

Your Cost: $21.27/claim|Median: $15.81
1.3× median
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