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Provider 1043544489

NPI: 1043544489Share
Active Billing Period:2018-01→2024-12(75 months)

Total Paid

$9.9M

$9,864,981

Total Claims

284K

Beneficiaries

184K

1.5 claims/patient

Avg Cost/Claim

$35

Monthly Spending Trend

Yearly Spending

2018
$3.6M
-0%
2019
$3.6M
-25%
2020
$2.7M
-100%
2021
$3K
+527%
2022
$20K
-50%
2023
$10K
+11%
2024
$11K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99285 (Emergency dept visit, high/urgent complexity)) accounts for 21% of total spending.

99285Normal range

Emergency dept visit, high/urgent complexity

$2.1M

33K claims · 20.9%

Your Cost: $62.03/claim|Median: $85.65
0.7× median
99214Normal range

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

$2.0M

37K claims · 20.3%

Your Cost: $53.67/claim|Median: $53.41
1.0× median
99284Normal range

Emergency dept visit, high complexity

$1.3M

26K claims · 13.1%

Your Cost: $49.11/claim|Median: $69.51
0.7× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$959K

50K claims · 9.7%

Your Cost: $19.25/claim|Median: $23.99
0.8× median
99213Normal range

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

$795K

19K claims · 8.1%

Your Cost: $41.42/claim|Median: $37.81
1.1× median
99283Normal range

Emergency dept visit, moderate complexity

$572K

19K claims · 5.8%

Your Cost: $29.45/claim|Median: $42.48
0.7× median
99231Normal range

Subsequent hospital care, per day, low complexity

$245K

19K claims · 2.5%

Your Cost: $13.21/claim|Median: $16.77
0.8× median
99291Normal range

Critical care, first 30-74 minutes

$213K

3,823 claims · 2.2%

Your Cost: $55.67/claim|Median: $101.24
0.5× median
99233Normal range

Subsequent hospital care, per day, high complexity

$200K

8,331 claims · 2.0%

Your Cost: $23.97/claim|Median: $35.30
0.7× median
99223Normal range

Initial hospital care, per day, high complexity

$151K

3,773 claims · 1.5%

Your Cost: $40.01/claim|Median: $67.32
0.6× median
99396Top 10%

Preventive medicine, established patient, age 40-64

$145K

1,205 claims · 1.5%

Your Cost: $120.10/claim|Median: $76.06
1.6× median
99203Normal range

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

$141K

2,930 claims · 1.4%

Your Cost: $47.97/claim|Median: $57.85
0.8× median
90853Normal range

Group psychotherapy

$115K

9,401 claims · 1.2%

Your Cost: $12.24/claim|Median: $25.02
0.5× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$88K

3,727 claims · 0.9%

Your Cost: $23.59/claim|Median: $37.22
0.6× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$84K

2,890 claims · 0.8%

Your Cost: $28.92/claim|Median: $43.85
0.7× median
90833Normal range

Psychotherapy, 30 min, add-on to E/M service

$77K

2,920 claims · 0.8%

Your Cost: $26.39/claim|Median: $38.83
0.7× median
99395Top 25%

Preventive medicine, established patient, age 18-39

$56K

487 claims · 0.6%

Your Cost: $114.41/claim|Median: $72.71
1.6× median
99254Normal range

$46K

601 claims · 0.5%

Your Cost: $77.20/claim|Median: $81.43
0.9× median
99204Normal range

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

$44K

643 claims · 0.4%

Your Cost: $68.98/claim|Median: $84.03
0.8× median
96127Top 25%

Brief emotional/behavioral assessment, per standardized instrument

$41K

6,121 claims · 0.4%

Your Cost: $6.76/claim|Median: $3.67
1.8× median
99221Normal range

Initial hospital care, straightforward/low

$32K

880 claims · 0.3%

Your Cost: $36.28/claim|Median: $39.96
0.9× median
99309Normal range

Nursing facility care, subsequent, low complexity

$28K

1,673 claims · 0.3%

Your Cost: $16.80/claim|Median: $14.00
1.2× median
99212Normal range

Office/outpatient visit, low complexity

$27K

1,344 claims · 0.3%

Your Cost: $19.88/claim|Median: $25.06
0.8× median
90674Normal range

$25K

2,327 claims · 0.3%

Your Cost: $10.73/claim|Median: $15.16
0.7× median
76801Normal range

Ultrasound, pregnant uterus, single fetus, first trimester

$24K

868 claims · 0.2%

Your Cost: $28.17/claim|Median: $58.16
0.5× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$23K

718 claims · 0.2%

Your Cost: $31.92/claim|Median: $40.11
0.8× median
76813Normal range

Ultrasound for fetal nuchal translucency measurement

$23K

782 claims · 0.2%

Your Cost: $28.82/claim|Median: $70.87
0.4× median
59025Normal range

Fetal non-stress test

$19K

497 claims · 0.2%

Your Cost: $39.15/claim|Median: $26.45
1.5× median
76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$19K

231 claims · 0.2%

Your Cost: $82.00/claim|Median: $106.79
0.8× median
99243Normal range

Office or other outpatient consultation, low complexity

$19K

237 claims · 0.2%

Your Cost: $79.02/claim|Median: $82.43
1.0× median
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