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

⚖️ Compare🖨️ Print Report

Provider 1043306574

NPI: 1043306574Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$12.7M

$12,743,820

Total Claims

434K

Beneficiaries

386K

1.1 claims/patient

Avg Cost/Claim

$29

Monthly Spending Trend

Yearly Spending

2018
$2.0M
-11%
2019
$1.8M
+24%
2020
$2.2M
+9%
2021
$2.4M
-36%
2022
$1.6M
+7%
2023
$1.7M
-38%
2024
$1.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 46% of total spending.

T1015Top 25%

Clinic visit/encounter, all-inclusive

$5.9M

32K claims · 45.9%

Your Cost: $180.88/claim|Median: $121.16
1.5× median
99213Normal range

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

$2.8M

154K claims · 21.6%

Your Cost: $17.83/claim|Median: $37.81
0.5× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$528K

23K claims · 4.1%

Your Cost: $22.51/claim|Median: $17.85
1.3× median
99393Normal range

Preventive medicine, established patient, age 5-11

$460K

9,159 claims · 3.6%

Your Cost: $50.17/claim|Median: $74.82
0.7× median
99392Normal range

Preventive medicine, established patient, age 1-4

$351K

7,923 claims · 2.8%

Your Cost: $44.30/claim|Median: $75.18
0.6× median
99394Normal range

Preventive medicine, established patient, age 12-17

$311K

5,851 claims · 2.4%

Your Cost: $53.19/claim|Median: $80.15
0.7× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$280K

7,818 claims · 2.2%

Your Cost: $35.86/claim|Median: $69.35
0.5× median
99212Normal range

Office/outpatient visit, low complexity

$172K

8,554 claims · 1.4%

Your Cost: $20.15/claim|Median: $25.06
0.8× median
90471Normal range

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

$163K

15K claims · 1.3%

Your Cost: $10.78/claim|Median: $9.80
1.1× median
99396Normal range

Preventive medicine, established patient, age 40-64

$136K

3,168 claims · 1.1%

Your Cost: $42.82/claim|Median: $76.06
0.6× median
90461Normal range

Immunization admin, additional vaccine, counseling

$134K

8,461 claims · 1.0%

Your Cost: $15.79/claim|Median: $6.93
2.3× median
59409Normal range

Vaginal delivery only

$128K

292 claims · 1.0%

Your Cost: $436.95/claim|Median: $619.91
0.7× median
99395Normal range

Preventive medicine, established patient, age 18-39

$122K

2,904 claims · 1.0%

Your Cost: $42.14/claim|Median: $72.71
0.6× median
99203Normal range

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

$107K

2,954 claims · 0.8%

Your Cost: $36.35/claim|Median: $57.85
0.6× median
99214Normal range

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

$103K

5,495 claims · 0.8%

Your Cost: $18.72/claim|Median: $53.41
0.4× median
97803Normal range

Medical nutrition therapy, reassessment, group, thirty minutes

$87K

3,010 claims · 0.7%

Your Cost: $28.88/claim|Median: $24.33
1.2× median
D0120Normal range

Periodic oral evaluation, established patient

$79K

3,913 claims · 0.6%

Your Cost: $20.10/claim|Median: $24.34
0.8× median
97802Normal range

Medical nutrition therapy, reassessment, individual, fifteen minutes

$70K

1,725 claims · 0.5%

Your Cost: $40.46/claim|Median: $12.70
3.2× median
90619Top 5%

$66K

631 claims · 0.5%

Your Cost: $104.21/claim|Median: $8.36
12.5× median
90472Normal range

Immunization administration, each additional vaccine

$59K

5,009 claims · 0.5%

Your Cost: $11.78/claim|Median: $11.79
1.0× median
90677Top 25%

$57K

456 claims · 0.4%

Your Cost: $124.44/claim|Median: $12.96
9.6× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$52K

9,115 claims · 0.4%

Your Cost: $5.74/claim|Median: $7.18
0.8× median
98940Normal range

$44K

5,946 claims · 0.3%

Your Cost: $7.45/claim|Median: $14.55
0.5× median
D0210Normal range

Intraoral, complete series of radiographic images

$39K

1,894 claims · 0.3%

Your Cost: $20.46/claim|Median: $46.33
0.4× median
99429Normal range

$37K

3,749 claims · 0.3%

Your Cost: $10.00/claim|Median: $28.58
0.3× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$32K

1,810 claims · 0.2%

Your Cost: $17.50/claim|Median: $32.07
0.5× median
90649Top 10%

$32K

533 claims · 0.2%

Your Cost: $59.19/claim|Median: $6.42
9.2× median
D1110Normal range

Prophylaxis, adult cleaning

$31K

2,464 claims · 0.2%

Your Cost: $12.52/claim|Median: $43.38
0.3× median
0011ANormal range

COVID-19 vaccine admin, Moderna, 1st dose

$29K

966 claims · 0.2%

Your Cost: $29.79/claim|Median: $25.93
1.1× median
90651Top 25%

HPV vaccine, 9-valent

$28K

699 claims · 0.2%

Your Cost: $39.78/claim|Median: $8.93
4.5× median
← All providersHow we detect fraud →