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

⚖️ Compare🖨️ Print Report

Provider 1023124625

NPI: 1023124625Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$12.0M

$12,048,574

Total Claims

206K

Beneficiaries

178K

1.2 claims/patient

Avg Cost/Claim

$58

Monthly Spending Trend

Yearly Spending

2018
$590K
+87%
2019
$1.1M
+41%
2020
$1.6M
+24%
2021
$1.9M
+13%
2022
$2.2M
+16%
2023
$2.5M
-15%
2024
$2.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (88305 (Surgical pathology, gross and microscopic examination)) accounts for 32% of total spending.

88305Top 5%

Surgical pathology, gross and microscopic examination

$3.8M

30K claims · 31.8%

Your Cost: $127.71/claim|Median: $35.80
3.6× median
99214Normal range

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

$2.5M

63K claims · 20.5%

Your Cost: $39.48/claim|Median: $53.41
0.7× median
88313Top 10%

$1.3M

18K claims · 10.5%

Your Cost: $71.81/claim|Median: $18.95
3.8× median
43239Normal range

Upper GI endoscopy with biopsy

$933K

21K claims · 7.7%

Your Cost: $44.31/claim|Median: $151.68
0.3× median
88342Top 25%

$773K

16K claims · 6.4%

Your Cost: $48.56/claim|Median: $23.66
2.1× median
99213Normal range

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

$428K

15K claims · 3.6%

Your Cost: $28.58/claim|Median: $37.81
0.8× median
45380Normal range

Colonoscopy with biopsy

$407K

4,905 claims · 3.4%

Your Cost: $83.07/claim|Median: $200.68
0.4× median
99203Normal range

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

$293K

7,201 claims · 2.4%

Your Cost: $40.65/claim|Median: $57.85
0.7× median
99204Normal range

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

$266K

4,049 claims · 2.2%

Your Cost: $65.74/claim|Median: $84.03
0.8× median
00813Normal range

$239K

3,316 claims · 2.0%

Your Cost: $72.16/claim|Median: $71.82
1.0× median
00731Normal range

$210K

3,614 claims · 1.7%

Your Cost: $58.00/claim|Median: $64.75
0.9× median
00811Normal range

$170K

3,001 claims · 1.4%

Your Cost: $56.79/claim|Median: $56.15
1.0× median
88312Top 25%

$169K

2,838 claims · 1.4%

Your Cost: $59.67/claim|Median: $24.56
2.4× median
00812Normal range

$126K

2,200 claims · 1.0%

Your Cost: $57.28/claim|Median: $59.54
1.0× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$125K

6,907 claims · 1.0%

Your Cost: $18.03/claim|Median: $23.99
0.8× median
45385Normal range

Colonoscopy with polyp removal, snare technique

$120K

1,131 claims · 1.0%

Your Cost: $106.42/claim|Median: $255.17
0.4× median
99254Normal range

$53K

780 claims · 0.4%

Your Cost: $68.12/claim|Median: $81.43
0.8× median
99244Normal range

Office or other outpatient consultation, moderate complexity

$36K

316 claims · 0.3%

Your Cost: $114.45/claim|Median: $121.58
0.9× median
99233Normal range

Subsequent hospital care, per day, high complexity

$36K

1,255 claims · 0.3%

Your Cost: $28.60/claim|Median: $35.30
0.8× median
99215Normal range

Office/outpatient visit, high complexity

$35K

811 claims · 0.3%

Your Cost: $42.78/claim|Median: $74.09
0.6× median
45378Normal range

Colonoscopy, diagnostic

$28K

320 claims · 0.2%

Your Cost: $88.06/claim|Median: $225.49
0.4× median
99243Normal range

Office or other outpatient consultation, low complexity

$11K

171 claims · 0.1%

Your Cost: $64.72/claim|Median: $82.43
0.8× median
91065Normal range

$5K

729 claims · 0.0%

Your Cost: $7.30/claim|Median: $37.81
0.2× median
99242Normal range

Office consultation, low complexity

$4K

89 claims · 0.0%

Your Cost: $48.94/claim|Median: $57.97
0.8× median
99443Normal range

Telephone E/M by physician, 21-30 min

$4K

137 claims · 0.0%

Your Cost: $26.66/claim|Median: $32.55
0.8× median
99253Normal range

$2K

40 claims · 0.0%

Your Cost: $48.52/claim|Median: $55.16
0.9× median
76981Normal range

$2K

63 claims · 0.0%

Your Cost: $24.74/claim|Median: $42.75
0.6× median
99231Normal range

Subsequent hospital care, per day, low complexity

$1K

119 claims · 0.0%

Your Cost: $12.16/claim|Median: $16.77
0.7× median
45384Normal range

$1K

12 claims · 0.0%

Your Cost: $89.46/claim|Median: $179.47
0.5× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$875

38 claims · 0.0%

Your Cost: $23.03/claim|Median: $40.11
0.6× median
← All providersHow we detect fraud →