Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

⚖️ Compare🖨️ Print Report

Provider 1013123231

NPI: 1013123231Share
Active Billing Period:2018-01→2022-04(51 months)
Billing appears to have stoppedLast active: 2022-04

Total Paid

$8.0M

$8,014,990

Total Claims

56K

Beneficiaries

52K

1.1 claims/patient

Avg Cost/Claim

$142

Monthly Spending Trend

Yearly Spending

2018
$196K
+1826%
2019
$3.8M
-44%
2020
$2.1M
-36%
2021
$1.4M
-58%
2022
$570K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 29 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 48% of total spending.

99214Top 5%

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

$3.9M

33K claims · 48.3%

Your Cost: $117.24/claim|Median: $53.41
2.2× median
99244Top 1%

Office or other outpatient consultation, moderate complexity

$1.1M

3,802 claims · 13.4%

Your Cost: $282.57/claim|Median: $121.58
2.3× median
99215Top 10%

Office/outpatient visit, high complexity

$709K

4,621 claims · 8.8%

Your Cost: $153.39/claim|Median: $74.09
2.1× median
95816Top 5%

$530K

1,662 claims · 6.6%

Your Cost: $318.94/claim|Median: $56.87
5.6× median
99213Top 10%

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

$321K

3,785 claims · 4.0%

Your Cost: $84.73/claim|Median: $37.81
2.2× median
95951Top 25%

$310K

766 claims · 3.9%

Your Cost: $404.83/claim|Median: $183.28
2.2× median
99232Top 5%

Subsequent hospital care, per day, moderate complexity

$282K

3,570 claims · 3.5%

Your Cost: $78.93/claim|Median: $23.99
3.3× median
99233Top 5%

Subsequent hospital care, per day, high complexity

$261K

1,895 claims · 3.3%

Your Cost: $137.81/claim|Median: $35.30
3.9× median
99204Top 5%

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

$210K

969 claims · 2.6%

Your Cost: $216.21/claim|Median: $84.03
2.6× median
99255Top 1%

$125K

356 claims · 1.6%

Your Cost: $351.17/claim|Median: $90.45
3.9× median
95810Normal range

Polysomnography, sleep study, 6+ hours

$63K

383 claims · 0.8%

Your Cost: $164.93/claim|Median: $233.73
0.7× median
95782Normal range

$54K

293 claims · 0.7%

Your Cost: $182.76/claim|Median: $216.35
0.8× median
95720Top 5%

$48K

145 claims · 0.6%

Your Cost: $328.46/claim|Median: $120.95
2.7× median
95940Top 1%

$27K

29 claims · 0.3%

Your Cost: $917.65/claim|Median: $149.65
6.1× median
95819Top 25%

Electroencephalogram with sleep recording

$25K

127 claims · 0.3%

Your Cost: $199.51/claim|Median: $62.75
3.2× median
99243Top 1%

Office or other outpatient consultation, low complexity

$24K

120 claims · 0.3%

Your Cost: $199.30/claim|Median: $82.43
2.4× median
95822Top 25%

$18K

220 claims · 0.2%

Your Cost: $80.63/claim|Median: $31.06
2.6× median
99205Top 5%

Office/outpatient visit, new patient, high complexity

$16K

54 claims · 0.2%

Your Cost: $288.20/claim|Median: $111.09
2.6× median
95957Normal range

$14K

230 claims · 0.2%

Your Cost: $61.75/claim|Median: $66.75
0.9× median
99222Top 1%

Initial hospital care, per day, moderate complexity

$10K

54 claims · 0.1%

Your Cost: $178.41/claim|Median: $51.25
3.5× median
99245Top 1%

Office consultation, high complexity

$9K

24 claims · 0.1%

Your Cost: $385.48/claim|Median: $143.30
2.7× median
99220Top 1%

$9K

32 claims · 0.1%

Your Cost: $265.65/claim|Median: $73.56
3.6× median
99203Top 5%

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

$4K

27 claims · 0.1%

Your Cost: $156.79/claim|Median: $57.85
2.7× median
99226Top 1%

$2K

13 claims · 0.0%

Your Cost: $176.01/claim|Median: $34.09
5.2× median
95939Normal range

$1K

28 claims · 0.0%

Your Cost: $45.23/claim|Median: $61.51
0.7× median
96120Top 10%

$1K

13 claims · 0.0%

Your Cost: $88.70/claim|Median: $19.72
4.5× median
99212Top 10%

Office/outpatient visit, low complexity

$940

15 claims · 0.0%

Your Cost: $62.64/claim|Median: $25.06
2.5× median
95938Normal range

$648

31 claims · 0.0%

Your Cost: $20.90/claim|Median: $26.58
0.8× median
95864Normal range

$222

13 claims · 0.0%

Your Cost: $17.11/claim|Median: $60.77
0.3× median
← All providersHow we detect fraud →