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Provider 1003398470

NPI: 1003398470Share
Active Billing Period:2019-01→2024-12(72 months)

Total Paid

$13.1M

$13,056,612

Total Claims

279K

Beneficiaries

263K

1.1 claims/patient

Avg Cost/Claim

$47

Monthly Spending Trend

Yearly Spending

2019
$2.1M
-8%
2020
$1.9M
+22%
2021
$2.3M
+7%
2022
$2.5M
+5%
2023
$2.6M
-36%
2024
$1.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 34% of total spending.

99214Top 25%

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

$4.5M

55K claims · 34.1%

Your Cost: $80.71/claim|Median: $53.41
1.5× median
99213Top 25%

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

$4.1M

74K claims · 31.8%

Your Cost: $56.25/claim|Median: $37.81
1.5× median
99396Normal range

Preventive medicine, established patient, age 40-64

$809K

8,471 claims · 6.2%

Your Cost: $95.47/claim|Median: $76.06
1.3× median
99395Normal range

Preventive medicine, established patient, age 18-39

$589K

6,829 claims · 4.5%

Your Cost: $86.20/claim|Median: $72.71
1.2× median
99392Normal range

Preventive medicine, established patient, age 1-4

$351K

4,460 claims · 2.7%

Your Cost: $78.64/claim|Median: $75.18
1.0× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$345K

4,764 claims · 2.6%

Your Cost: $72.34/claim|Median: $69.35
1.0× median
99394Normal range

Preventive medicine, established patient, age 12-17

$290K

3,415 claims · 2.2%

Your Cost: $84.82/claim|Median: $80.15
1.1× median
99393Normal range

Preventive medicine, established patient, age 5-11

$290K

3,697 claims · 2.2%

Your Cost: $78.34/claim|Median: $74.82
1.0× median
99215Top 25%

Office/outpatient visit, high complexity

$222K

2,054 claims · 1.7%

Your Cost: $108.26/claim|Median: $74.09
1.5× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$192K

8,465 claims · 1.5%

Your Cost: $22.69/claim|Median: $17.85
1.3× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$149K

4,061 claims · 1.1%

Your Cost: $36.72/claim|Median: $23.99
1.5× median
99204Top 25%

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

$143K

1,207 claims · 1.1%

Your Cost: $118.78/claim|Median: $84.03
1.4× median
99496Top 25%

Transitional care management, moderate complexity face-to-face visit

$102K

857 claims · 0.8%

Your Cost: $118.96/claim|Median: $54.66
2.2× median
99212Normal range

Office/outpatient visit, low complexity

$67K

2,069 claims · 0.5%

Your Cost: $32.49/claim|Median: $25.06
1.3× median
99203Top 25%

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

$67K

829 claims · 0.5%

Your Cost: $80.36/claim|Median: $57.85
1.4× median
90682Normal range

$66K

1,388 claims · 0.5%

Your Cost: $47.33/claim|Median: $34.72
1.4× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$65K

8,899 claims · 0.5%

Your Cost: $7.34/claim|Median: $9.56
0.8× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$65K

5,184 claims · 0.5%

Your Cost: $12.55/claim|Median: $11.48
1.1× median
99443Top 25%

Telephone E/M by physician, 21-30 min

$49K

582 claims · 0.4%

Your Cost: $84.61/claim|Median: $32.55
2.6× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$42K

1,079 claims · 0.3%

Your Cost: $38.99/claim|Median: $37.22
1.0× median
90471Normal range

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

$42K

4,306 claims · 0.3%

Your Cost: $9.70/claim|Median: $9.80
1.0× median
99309Top 5%

Nursing facility care, subsequent, low complexity

$32K

527 claims · 0.2%

Your Cost: $61.36/claim|Median: $14.00
4.4× median
83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$29K

5,014 claims · 0.2%

Your Cost: $5.80/claim|Median: $5.50
1.1× median
99442Top 25%

Telephone E/M by physician, 11-20 minutes

$29K

492 claims · 0.2%

Your Cost: $58.84/claim|Median: $22.44
2.6× median
87804Normal range

Influenza virus detection, rapid test

$28K

2,090 claims · 0.2%

Your Cost: $13.35/claim|Median: $12.59
1.1× median
81002Normal range

Urinalysis, non-automated without microscopy

$24K

9,687 claims · 0.2%

Your Cost: $2.49/claim|Median: $2.00
1.2× median
20610Normal range

Arthrocentesis, aspiration/injection, major joint

$21K

800 claims · 0.2%

Your Cost: $25.81/claim|Median: $29.03
0.9× median
99223Top 25%

Initial hospital care, per day, high complexity

$20K

187 claims · 0.2%

Your Cost: $106.17/claim|Median: $67.32
1.6× median
93000Normal range

Electrocardiogram, complete, with interpretation and report

$19K

2,583 claims · 0.1%

Your Cost: $7.33/claim|Median: $9.70
0.8× median
J1040Normal range

$18K

1,859 claims · 0.1%

Your Cost: $9.44/claim|Median: $6.87
1.4× median
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