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Provider 1013386846

NPI: 1013386846Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$9.9M

$9,895,129

Total Claims

251K

Beneficiaries

226K

1.1 claims/patient

Avg Cost/Claim

$39

Monthly Spending Trend

Yearly Spending

2018
$35K
-4%
2019
$33K
+4814%
2020
$1.6M
+45%
2021
$2.4M
+3%
2022
$2.5M
-27%
2023
$1.8M
-12%
2024
$1.6M

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 40% of total spending.

99213Top 5%

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

$3.9M

45K claims · 39.6%

Your Cost: $87.98/claim|Median: $37.81
2.3× median
99214Top 5%

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

$1.7M

14K claims · 17.1%

Your Cost: $116.89/claim|Median: $53.41
2.2× median
99394Top 10%

Preventive medicine, established patient, age 12-17

$727K

6,182 claims · 7.3%

Your Cost: $117.63/claim|Median: $80.15
1.5× median
99393Top 10%

Preventive medicine, established patient, age 5-11

$640K

5,988 claims · 6.5%

Your Cost: $106.83/claim|Median: $74.82
1.4× median
99392Top 10%

Preventive medicine, established patient, age 1-4

$472K

4,406 claims · 4.8%

Your Cost: $107.02/claim|Median: $75.18
1.4× median
99391Top 25%

Preventive medicine, established patient, infant (under 1)

$342K

3,474 claims · 3.5%

Your Cost: $98.33/claim|Median: $69.35
1.4× median
92552Top 25%

Pure tone audiometry, air only, each ear

$229K

9,298 claims · 2.3%

Your Cost: $24.64/claim|Median: $12.63
2.0× median
87636Top 25%

Respiratory virus detection, 6-11 targets, nucleic acid

$176K

1,284 claims · 1.8%

Your Cost: $136.82/claim|Median: $97.61
1.4× median
D1206Top 25%

Topical application of fluoride varnish

$159K

6,448 claims · 1.6%

Your Cost: $24.65/claim|Median: $18.12
1.4× median
90686Top 5%

Influenza virus vaccine, quadrivalent, preservative-free, IM

$121K

5,468 claims · 1.2%

Your Cost: $22.19/claim|Median: $7.18
3.1× median
99212Top 25%

Office/outpatient visit, low complexity

$120K

2,338 claims · 1.2%

Your Cost: $51.53/claim|Median: $25.06
2.1× median
85025Top 25%

Complete blood count (CBC) with differential, automated

$93K

13K claims · 0.9%

Your Cost: $6.97/claim|Median: $4.71
1.5× median
96127Top 25%

Brief emotional/behavioral assessment, per standardized instrument

$87K

10K claims · 0.9%

Your Cost: $8.39/claim|Median: $3.67
2.3× median
99395Top 25%

Preventive medicine, established patient, age 18-39

$87K

768 claims · 0.9%

Your Cost: $113.34/claim|Median: $72.71
1.6× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$84K

6,728 claims · 0.8%

Your Cost: $12.50/claim|Median: $11.48
1.1× median
87804Normal range

Influenza virus detection, rapid test

$81K

7,481 claims · 0.8%

Your Cost: $10.89/claim|Median: $12.59
0.9× median
92551Normal range

Screening audiometry, pure tone, air only

$61K

6,599 claims · 0.6%

Your Cost: $9.29/claim|Median: $6.61
1.4× median
96110Normal range

Developmental screening, per standardized instrument

$59K

4,608 claims · 0.6%

Your Cost: $12.79/claim|Median: $9.10
1.4× median
90677Top 25%

$51K

638 claims · 0.5%

Your Cost: $79.40/claim|Median: $12.96
6.1× median
94760Normal range

Pulse oximetry, single reading, noninvasive

$50K

26K claims · 0.5%

Your Cost: $1.95/claim|Median: $0.79
2.5× median
99215Top 10%

Office/outpatient visit, high complexity

$49K

329 claims · 0.5%

Your Cost: $149.12/claim|Median: $74.09
2.0× median
90651Top 25%

HPV vaccine, 9-valent

$47K

2,033 claims · 0.5%

Your Cost: $23.18/claim|Median: $8.93
2.6× median
90670Top 25%

$42K

1,916 claims · 0.4%

Your Cost: $22.03/claim|Median: $5.94
3.7× median
99177Normal range

$41K

8,401 claims · 0.4%

Your Cost: $4.91/claim|Median: $3.74
1.3× median
90698Top 10%

$29K

1,282 claims · 0.3%

Your Cost: $22.59/claim|Median: $6.32
3.6× median
G2023Normal range

Specimen collection for COVID-19 testing

$28K

1,332 claims · 0.3%

Your Cost: $20.92/claim|Median: $17.15
1.2× median
81002Normal range

Urinalysis, non-automated without microscopy

$27K

10K claims · 0.3%

Your Cost: $2.55/claim|Median: $2.00
1.3× median
90620Top 25%

$26K

1,146 claims · 0.3%

Your Cost: $22.86/claim|Median: $6.49
3.5× median
90633Top 5%

$26K

1,154 claims · 0.3%

Your Cost: $22.55/claim|Median: $3.56
6.3× median
90680Top 5%

$25K

1,140 claims · 0.3%

Your Cost: $21.83/claim|Median: $5.58
3.9× median
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