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Provider 1003963497

NPI: 1003963497Share
Active Billing Period:2018-01→2024-12(80 months)

Total Paid

$10.8M

$10,807,559

Total Claims

30K

Beneficiaries

27K

1.1 claims/patient

Avg Cost/Claim

$357

Monthly Spending Trend

Yearly Spending

2018
$173K
+6%
2019
$182K
-84%
2020
$30K
+8413%
2021
$2.5M
+8%
2022
$2.7M
-6%
2023
$2.6M
+1%
2024
$2.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 49% of total spending.

99213Top 1%

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

$5.3M

11K claims · 49.3%

Your Cost: $488.08/claim|Median: $37.81
12.9× median
99211Top 1%

Office/outpatient visit, minimal complexity

$1.5M

4,323 claims · 14.0%

Your Cost: $350.21/claim|Median: $12.93
27.1× median
99214Top 1%

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

$943K

2,243 claims · 8.7%

Your Cost: $420.20/claim|Median: $53.41
7.9× median
99212Top 1%

Office/outpatient visit, low complexity

$603K

1,192 claims · 5.6%

Your Cost: $505.63/claim|Median: $25.06
20.2× median
92012Top 1%

Ophthalmological exam, intermediate, established patient

$376K

906 claims · 3.5%

Your Cost: $415.47/claim|Median: $38.23
10.9× median
W0037Top 25%

$223K

6,992 claims · 2.1%

Your Cost: $31.83/claim|Median: $3.00
10.6× median
90834Top 1%

Psychotherapy, 45 minutes

$220K

385 claims · 2.0%

Your Cost: $571.84/claim|Median: $63.65
9.0× median
90471Top 1%

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

$211K

326 claims · 1.9%

Your Cost: $645.82/claim|Median: $9.80
65.9× median
90837Top 1%

Psychotherapy, 60 minutes

$201K

431 claims · 1.9%

Your Cost: $466.81/claim|Median: $85.66
5.4× median
0002ATop 1%

COVID-19 vaccine admin, Pfizer, 2nd dose

$188K

386 claims · 1.7%

Your Cost: $487.40/claim|Median: $36.70
13.3× median
0001ATop 1%

COVID-19 vaccine admin, Pfizer, 1st dose

$187K

393 claims · 1.7%

Your Cost: $476.74/claim|Median: $33.72
14.1× median
0072ATop 1%

$154K

269 claims · 1.4%

Your Cost: $572.88/claim|Median: $39.57
14.5× median
0071ATop 1%

$111K

202 claims · 1.0%

Your Cost: $548.07/claim|Median: $38.71
14.2× median
90832Top 1%

Psychotherapy, 30 minutes

$107K

181 claims · 1.0%

Your Cost: $591.28/claim|Median: $41.28
14.3× median
90791Top 1%

Psychiatric diagnostic evaluation

$95K

153 claims · 0.9%

Your Cost: $623.82/claim|Median: $99.21
6.3× median
99394Top 1%

Preventive medicine, established patient, age 12-17

$87K

162 claims · 0.8%

Your Cost: $539.28/claim|Median: $80.15
6.7× median
99393Top 1%

Preventive medicine, established patient, age 5-11

$53K

89 claims · 0.5%

Your Cost: $597.29/claim|Median: $74.82
8.0× median
99391Top 1%

Preventive medicine, established patient, infant (under 1)

$39K

56 claims · 0.4%

Your Cost: $691.07/claim|Median: $69.35
10.0× median
D0220Top 1%

Intraoral periapical radiographic image, first film

$35K

192 claims · 0.3%

Your Cost: $182.03/claim|Median: $10.51
17.3× median
0011ATop 1%

COVID-19 vaccine admin, Moderna, 1st dose

$18K

36 claims · 0.2%

Your Cost: $504.58/claim|Median: $25.93
19.5× median
0012ATop 1%

COVID-19 vaccine admin, Moderna, 2nd dose

$17K

37 claims · 0.2%

Your Cost: $462.89/claim|Median: $33.85
13.7× median
99392Top 1%

Preventive medicine, established patient, age 1-4

$16K

26 claims · 0.2%

Your Cost: $624.19/claim|Median: $75.18
8.3× median
0052ATop 1%

$15K

24 claims · 0.1%

Your Cost: $640.00/claim|Median: $37.79
16.9× median
99215Top 1%

Office/outpatient visit, high complexity

$13K

27 claims · 0.1%

Your Cost: $479.33/claim|Median: $74.09
6.5× median
0004ATop 1%

$10K

32 claims · 0.1%

Your Cost: $312.44/claim|Median: $35.62
8.8× median
0051ATop 1%

$10K

16 claims · 0.1%

Your Cost: $600.00/claim|Median: $36.92
16.3× median
0081ATop 1%

$9K

14 claims · 0.1%

Your Cost: $640.00/claim|Median: $38.21
16.7× median
0054ATop 5%

$8K

14 claims · 0.1%

Your Cost: $548.57/claim|Median: $35.83
15.3× median
0082ATop 1%

$7K

13 claims · 0.1%

Your Cost: $541.54/claim|Median: $39.88
13.6× median
D0210Top 1%

Intraoral, complete series of radiographic images

$4K

12 claims · 0.0%

Your Cost: $341.25/claim|Median: $46.33
7.4× median
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