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Provider 1043469042

NPI: 1043469042Share
Active Billing Period:2018-01→2024-10(82 months)

Total Paid

$14.9M

$14,903,523

Total Claims

324K

Beneficiaries

251K

1.3 claims/patient

Avg Cost/Claim

$46

Monthly Spending Trend

Yearly Spending

2018
$1.0M
+78%
2019
$1.8M
-4%
2020
$1.7M
+60%
2021
$2.8M
+9%
2022
$3.0M
-11%
2023
$2.7M
-29%
2024
$1.9M

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 72% of total spending.

99213Top 5%

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

$10.7M

123K claims · 71.9%

Your Cost: $87.40/claim|Median: $37.81
2.3× median
99214Top 10%

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

$978K

9,367 claims · 6.6%

Your Cost: $104.44/claim|Median: $53.41
2.0× median
99395Top 10%

Preventive medicine, established patient, age 18-39

$492K

4,141 claims · 3.3%

Your Cost: $118.80/claim|Median: $72.71
1.6× median
99212Top 10%

Office/outpatient visit, low complexity

$435K

7,626 claims · 2.9%

Your Cost: $57.09/claim|Median: $25.06
2.3× median
99396Top 10%

Preventive medicine, established patient, age 40-64

$415K

3,254 claims · 2.8%

Your Cost: $127.66/claim|Median: $76.06
1.7× median
99203Top 10%

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

$217K

1,930 claims · 1.5%

Your Cost: $112.36/claim|Median: $57.85
1.9× median
99442Top 10%

Telephone E/M by physician, 11-20 minutes

$153K

1,903 claims · 1.0%

Your Cost: $80.51/claim|Median: $22.44
3.6× median
99394Top 10%

Preventive medicine, established patient, age 12-17

$150K

1,272 claims · 1.0%

Your Cost: $118.03/claim|Median: $80.15
1.5× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$138K

5,983 claims · 0.9%

Your Cost: $23.03/claim|Median: $17.85
1.3× median
90471Top 25%

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

$132K

7,204 claims · 0.9%

Your Cost: $18.34/claim|Median: $9.80
1.9× median
92552Top 10%

Pure tone audiometry, air only, each ear

$120K

3,756 claims · 0.8%

Your Cost: $31.96/claim|Median: $12.63
2.5× median
G0444Top 10%

Annual depression screening, fifteen minutes

$113K

6,967 claims · 0.8%

Your Cost: $16.25/claim|Median: $4.23
3.8× median
99393Top 10%

Preventive medicine, established patient, age 5-11

$94K

892 claims · 0.6%

Your Cost: $105.70/claim|Median: $74.82
1.4× median
93000Normal range

Electrocardiogram, complete, with interpretation and report

$74K

6,326 claims · 0.5%

Your Cost: $11.76/claim|Median: $9.70
1.2× median
90746Top 25%

Hepatitis B vaccine, adult

$74K

1,145 claims · 0.5%

Your Cost: $64.44/claim|Median: $48.85
1.3× median
90756Top 25%

Influenza virus vaccine, quadrivalent

$72K

2,775 claims · 0.5%

Your Cost: $25.82/claim|Median: $14.34
1.8× median
99443Top 10%

Telephone E/M by physician, 21-30 min

$47K

428 claims · 0.3%

Your Cost: $109.60/claim|Median: $32.55
3.4× median
G0101Top 25%

Cervical/vaginal cancer screening; pelvic exam

$44K

1,326 claims · 0.3%

Your Cost: $33.14/claim|Median: $21.28
1.6× median
94010Top 10%

$44K

1,137 claims · 0.3%

Your Cost: $38.36/claim|Median: $18.11
2.1× median
90674Normal range

$38K

1,669 claims · 0.3%

Your Cost: $22.91/claim|Median: $15.16
1.5× median
83013Top 25%

$31K

462 claims · 0.2%

Your Cost: $68.07/claim|Median: $46.17
1.5× median
G0108Normal range

Diabetes self-management training, individual

$31K

1,422 claims · 0.2%

Your Cost: $21.59/claim|Median: $35.89
0.6× median
99441Top 10%

Telephone E/M by physician, 5-10 min

$22K

425 claims · 0.1%

Your Cost: $52.52/claim|Median: $13.30
3.9× median
90651Top 10%

HPV vaccine, 9-valent

$17K

245 claims · 0.1%

Your Cost: $70.95/claim|Median: $8.93
7.9× median
99051Normal range

$17K

5,848 claims · 0.1%

Your Cost: $2.84/claim|Median: $7.89
0.4× median
G8510Normal range

$16K

6,949 claims · 0.1%

Your Cost: $2.34/claim|Median: $1.96
1.2× median
90715Top 25%

Tdap vaccine

$16K

635 claims · 0.1%

Your Cost: $25.31/claim|Median: $10.32
2.5× median
3074FTop 25%

$16K

8,954 claims · 0.1%

Your Cost: $1.77/claim|Median: $0.11
16.1× median
3078FTop 25%

$15K

9,014 claims · 0.1%

Your Cost: $1.71/claim|Median: $0.08
21.4× median
0064ATop 25%

$13K

320 claims · 0.1%

Your Cost: $40.55/claim|Median: $34.17
1.2× median
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