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

⚖️ Compare🖨️ Print Report

Provider 1043497571

NPI: 1043497571Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$7.6M

$7,626,391

Total Claims

127K

Beneficiaries

98K

1.3 claims/patient

Avg Cost/Claim

$60

Monthly Spending Trend

Yearly Spending

2018
$341K
+245%
2019
$1.2M
-3%
2020
$1.1M
-29%
2021
$815K
+63%
2022
$1.3M
+25%
2023
$1.7M
-30%
2024
$1.2M

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 26% of total spending.

99213Normal range

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

$2.0M

43K claims · 26.4%

Your Cost: $46.53/claim|Median: $37.81
1.2× median
95911Normal range

$1.4M

13K claims · 18.4%

Your Cost: $110.54/claim|Median: $122.86
0.9× median
95886Normal range

$990K

10K claims · 13.0%

Your Cost: $96.43/claim|Median: $67.70
1.4× median
93892Normal range

$477K

3,923 claims · 6.3%

Your Cost: $121.67/claim|Median: $87.42
1.4× median
93890Normal range

$437K

3,933 claims · 5.7%

Your Cost: $111.22/claim|Median: $94.81
1.2× median
95813Top 25%

$383K

1,281 claims · 5.0%

Your Cost: $298.62/claim|Median: $121.48
2.5× median
99214Normal range

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

$365K

7,032 claims · 4.8%

Your Cost: $51.87/claim|Median: $53.41
1.0× median
93886Normal range

$330K

3,902 claims · 4.3%

Your Cost: $84.47/claim|Median: $83.25
1.0× median
95816Normal range

$204K

1,831 claims · 2.7%

Your Cost: $111.28/claim|Median: $56.87
2.0× median
99203Normal range

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

$190K

2,955 claims · 2.5%

Your Cost: $64.37/claim|Median: $57.85
1.1× median
90868Normal range

$164K

2,156 claims · 2.2%

Your Cost: $76.19/claim|Median: $140.66
0.5× median
92546Normal range

$130K

3,951 claims · 1.7%

Your Cost: $32.93/claim|Median: $52.33
0.6× median
97140Normal range

Manual therapy techniques, per 15 minutes

$127K

6,352 claims · 1.7%

Your Cost: $19.98/claim|Median: $16.79
1.2× median
92540Normal range

$101K

2,006 claims · 1.3%

Your Cost: $50.20/claim|Median: $59.84
0.8× median
95923Normal range

$69K

1,607 claims · 0.9%

Your Cost: $42.77/claim|Median: $44.24
1.0× median
93922Normal range

$48K

1,531 claims · 0.6%

Your Cost: $31.24/claim|Median: $26.06
1.2× median
95921Normal range

$47K

1,602 claims · 0.6%

Your Cost: $29.49/claim|Median: $31.18
0.9× median
97110Normal range

Therapeutic exercises, each 15 min

$33K

8,023 claims · 0.4%

Your Cost: $4.08/claim|Median: $24.49
0.2× median
97161Normal range

Physical therapy evaluation, low complexity

$21K

743 claims · 0.3%

Your Cost: $28.80/claim|Median: $47.89
0.6× median
76942Normal range

$20K

730 claims · 0.3%

Your Cost: $27.54/claim|Median: $24.73
1.1× median
20553Normal range

$16K

650 claims · 0.2%

Your Cost: $24.80/claim|Median: $29.47
0.8× median
99243Normal range

Office or other outpatient consultation, low complexity

$14K

214 claims · 0.2%

Your Cost: $66.92/claim|Median: $82.43
0.8× median
92547Normal range

$9K

1,822 claims · 0.1%

Your Cost: $4.72/claim|Median: $3.63
1.3× median
J1030Top 5%

Injection, methylprednisolone acetate, forty milligrams

$6K

309 claims · 0.1%

Your Cost: $18.75/claim|Median: $4.38
4.3× median
97530Normal range

Therapeutic activities, each 15 min

$5K

1,305 claims · 0.1%

Your Cost: $3.80/claim|Median: $33.11
0.1× median
92548Normal range

$3K

125 claims · 0.0%

Your Cost: $27.34/claim|Median: $27.60
1.0× median
90867Normal range

$2K

27 claims · 0.0%

Your Cost: $90.66/claim|Median: $253.60
0.4× median
99401Top 25%

$2K

80 claims · 0.0%

Your Cost: $26.47/claim|Median: $16.53
1.6× median
92537Normal range

$2K

236 claims · 0.0%

Your Cost: $8.37/claim|Median: $24.39
0.3× median
99244Normal range

Office or other outpatient consultation, moderate complexity

$2K

31 claims · 0.0%

Your Cost: $63.34/claim|Median: $121.58
0.5× median
← All providersHow we detect fraud →