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Provider 1043203136

NPI: 1043203136Share
Active Billing Period:2018-01→2024-06(78 months)

Total Paid

$7.8M

$7,849,722

Total Claims

54K

Beneficiaries

39K

1.4 claims/patient

Avg Cost/Claim

$146

Monthly Spending Trend

Yearly Spending

2018
$1.5M
-0%
2019
$1.5M
-5%
2020
$1.4M
+4%
2021
$1.5M
-14%
2022
$1.2M
-46%
2023
$668K
-83%
2024
$115K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 25 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 28% of total spending.

99213Top 5%

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

$2.2M

15K claims · 27.6%

Your Cost: $145.42/claim|Median: $37.81
3.8× median
99212Top 5%

Office/outpatient visit, low complexity

$1.9M

13K claims · 24.0%

Your Cost: $145.19/claim|Median: $25.06
5.8× median
59426Normal range

Antepartum care only, high risk, additional visits

$1.8M

12K claims · 23.3%

Your Cost: $158.43/claim|Median: $122.30
1.3× median
59425Top 25%

Antepartum care only, 4-6 visits

$778K

5,106 claims · 9.9%

Your Cost: $152.29/claim|Median: $63.63
2.4× median
99214Top 5%

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

$627K

4,128 claims · 8.0%

Your Cost: $151.87/claim|Median: $53.41
2.8× median
59515Normal range

$171K

191 claims · 2.2%

Your Cost: $894.09/claim|Median: $786.24
1.1× median
99234Normal range

$157K

1,988 claims · 2.0%

Your Cost: $78.99/claim|Median: $80.89
1.0× median
59410Normal range

$136K

209 claims · 1.7%

Your Cost: $650.49/claim|Median: $781.64
0.8× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$45K

383 claims · 0.6%

Your Cost: $116.83/claim|Median: $108.91
1.1× median
99218Normal range

$33K

511 claims · 0.4%

Your Cost: $63.64/claim|Median: $51.50
1.2× median
99217Normal range

$11K

328 claims · 0.1%

Your Cost: $34.08/claim|Median: $31.89
1.1× median
49320Normal range

$3K

15 claims · 0.0%

Your Cost: $185.16/claim|Median: $203.61
0.9× median
99201Top 5%

Office/outpatient visit, new patient, straightforward

$2K

14 claims · 0.0%

Your Cost: $168.35/claim|Median: $27.38
6.1× median
59025Normal range

Fetal non-stress test

$2K

148 claims · 0.0%

Your Cost: $12.76/claim|Median: $26.45
0.5× median
99395Top 5%

Preventive medicine, established patient, age 18-39

$2K

14 claims · 0.0%

Your Cost: $129.66/claim|Median: $72.71
1.8× median
99211Top 5%

Office/outpatient visit, minimal complexity

$1K

16 claims · 0.0%

Your Cost: $87.45/claim|Median: $12.93
6.8× median
99222Normal range

Initial hospital care, per day, moderate complexity

$1K

30 claims · 0.0%

Your Cost: $45.68/claim|Median: $51.25
0.9× median
76818Normal range

$420

75 claims · 0.0%

Your Cost: $5.60/claim|Median: $68.15
0.1× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$302

18 claims · 0.0%

Your Cost: $16.77/claim|Median: $37.22
0.5× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$248

34 claims · 0.0%

Your Cost: $7.29/claim|Median: $40.11
0.2× median
81002Normal range

Urinalysis, non-automated without microscopy

$3

116 claims · 0.0%

Your Cost: $0.03/claim|Median: $2.00
0.0× median
82948Normal range

$0

13 claims · 0.0%

Your Cost: $0.00/claim|Median: $1.78
76817Normal range

Ultrasound, pregnant uterus, transvaginal

$0

27 claims · 0.0%

Your Cost: $0.00/claim|Median: $47.65
81025Normal range

Urine pregnancy test

$0

79 claims · 0.0%

Your Cost: $0.00/claim|Median: $4.81
0502FNormal range

$0

811 claims · 0.0%

Your Cost: $0.00/claim|Median: $44.10
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