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Provider 1053344473

NPI: 1053344473Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$8.3M

$8,303,254

Total Claims

158K

Beneficiaries

135K

1.2 claims/patient

Avg Cost/Claim

$53

Monthly Spending Trend

Yearly Spending

2018
$1.0M
-5%
2019
$993K
+18%
2020
$1.2M
+23%
2021
$1.4M
-10%
2022
$1.3M
-3%
2023
$1.3M
-15%
2024
$1.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 72% of total spending.

99214Top 25%

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

$6.0M

71K claims · 72.0%

Your Cost: $83.67/claim|Median: $53.41
1.6× median
99213Top 25%

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

$720K

13K claims · 8.7%

Your Cost: $54.81/claim|Median: $37.81
1.4× median
99401Top 10%

$557K

16K claims · 6.7%

Your Cost: $34.18/claim|Median: $16.53
2.1× median
99491Normal range

$189K

10K claims · 2.3%

Your Cost: $18.82/claim|Median: $9.86
1.9× median
96127Top 5%

Brief emotional/behavioral assessment, per standardized instrument

$143K

7,868 claims · 1.7%

Your Cost: $18.23/claim|Median: $3.67
5.0× median
96160Top 10%

Patient-focused health risk assessment

$107K

6,036 claims · 1.3%

Your Cost: $17.69/claim|Median: $2.10
8.4× median
99490Normal range

Chronic care management services, 20 minutes per month

$95K

8,132 claims · 1.1%

Your Cost: $11.72/claim|Median: $6.31
1.9× median
99215Top 25%

Office/outpatient visit, high complexity

$85K

679 claims · 1.0%

Your Cost: $124.97/claim|Median: $74.09
1.7× median
93000Normal range

Electrocardiogram, complete, with interpretation and report

$65K

5,615 claims · 0.8%

Your Cost: $11.54/claim|Median: $9.70
1.2× median
99396Top 25%

Preventive medicine, established patient, age 40-64

$60K

520 claims · 0.7%

Your Cost: $115.70/claim|Median: $76.06
1.5× median
99204Top 10%

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

$54K

364 claims · 0.6%

Your Cost: $147.14/claim|Median: $84.03
1.8× median
99402Top 25%

$30K

515 claims · 0.4%

Your Cost: $59.11/claim|Median: $31.79
1.9× median
99443Normal range

Telephone E/M by physician, 21-30 min

$30K

622 claims · 0.4%

Your Cost: $48.82/claim|Median: $32.55
1.5× median
99395Top 25%

Preventive medicine, established patient, age 18-39

$30K

288 claims · 0.4%

Your Cost: $103.69/claim|Median: $72.71
1.4× median
99408Top 25%

$25K

973 claims · 0.3%

Your Cost: $25.60/claim|Median: $9.32
2.7× median
99404Normal range

$18K

160 claims · 0.2%

Your Cost: $110.27/claim|Median: $104.92
1.1× median
99487Top 25%

$14K

382 claims · 0.2%

Your Cost: $37.92/claim|Median: $14.74
2.6× median
99397Top 10%

$14K

142 claims · 0.2%

Your Cost: $98.74/claim|Median: $22.92
4.3× median
99407Top 10%

$12K

481 claims · 0.1%

Your Cost: $25.38/claim|Median: $13.29
1.9× median
99374Normal range

$11K

470 claims · 0.1%

Your Cost: $22.44/claim|Median: $25.00
0.9× median
99442Normal range

Telephone E/M by physician, 11-20 minutes

$9K

267 claims · 0.1%

Your Cost: $34.72/claim|Median: $22.44
1.5× median
99406Top 25%

$9K

809 claims · 0.1%

Your Cost: $10.96/claim|Median: $6.53
1.7× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$7K

660 claims · 0.1%

Your Cost: $10.66/claim|Median: $9.56
1.1× median
99385Top 10%

Preventive visit, new patient, 18-39 yr

$7K

53 claims · 0.1%

Your Cost: $127.24/claim|Median: $76.22
1.7× median
99203Top 25%

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

$6K

70 claims · 0.1%

Your Cost: $85.09/claim|Median: $57.85
1.5× median
99454Normal range

$5K

378 claims · 0.1%

Your Cost: $14.54/claim|Median: $9.15
1.6× median
G0179Top 25%

Physician recertification for home health plan of care

$4K

365 claims · 0.1%

Your Cost: $12.15/claim|Median: $6.63
1.8× median
94060Normal range

$3K

94 claims · 0.0%

Your Cost: $32.82/claim|Median: $25.18
1.3× median
G2211Normal range

$2K

655 claims · 0.0%

Your Cost: $3.35/claim|Median: $2.40
1.4× median
99484Normal range

$2K

125 claims · 0.0%

Your Cost: $16.23/claim|Median: $7.13
2.3× median
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