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Provider 1053469486

NPI: 1053469486Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$16.9M

$16,919,486

Total Claims

619K

Beneficiaries

532K

1.2 claims/patient

Avg Cost/Claim

$27

Monthly Spending Trend

Yearly Spending

2018
$2.9M
-6%
2019
$2.7M
-18%
2020
$2.2M
+31%
2021
$2.9M
-12%
2022
$2.5M
-22%
2023
$2.0M
-12%
2024
$1.8M

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 42% of total spending.

99214Normal range

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

$7.1M

127K claims · 42.2%

Your Cost: $56.34/claim|Median: $53.41
1.1× median
99213Normal range

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

$5.5M

129K claims · 32.6%

Your Cost: $42.93/claim|Median: $37.81
1.1× median
87428Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay, each

$1.1M

26K claims · 6.7%

Your Cost: $42.75/claim|Median: $39.63
1.1× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$491K

43K claims · 2.9%

Your Cost: $11.46/claim|Median: $11.48
1.0× median
87426Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$403K

14K claims · 2.4%

Your Cost: $28.40/claim|Median: $30.04
0.9× median
87804Normal range

Influenza virus detection, rapid test

$272K

22K claims · 1.6%

Your Cost: $12.45/claim|Median: $12.59
1.0× median
99203Normal range

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

$255K

3,716 claims · 1.5%

Your Cost: $68.76/claim|Median: $57.85
1.2× median
99215Normal range

Office/outpatient visit, high complexity

$209K

3,496 claims · 1.2%

Your Cost: $59.83/claim|Median: $74.09
0.8× median
99204Normal range

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

$181K

1,945 claims · 1.1%

Your Cost: $93.08/claim|Median: $84.03
1.1× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$149K

22K claims · 0.9%

Your Cost: $6.77/claim|Median: $9.56
0.7× median
59426Normal range

Antepartum care only, high risk, additional visits

$122K

1,398 claims · 0.7%

Your Cost: $87.07/claim|Median: $122.30
0.7× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$107K

5,753 claims · 0.6%

Your Cost: $18.56/claim|Median: $23.99
0.8× median
85025Normal range

Complete blood count (CBC) with differential, automated

$97K

31K claims · 0.6%

Your Cost: $3.15/claim|Median: $4.71
0.7× median
80053Normal range

Comprehensive metabolic panel

$80K

20K claims · 0.5%

Your Cost: $4.07/claim|Median: $7.24
0.6× median
99309Normal range

Nursing facility care, subsequent, low complexity

$74K

5,355 claims · 0.4%

Your Cost: $13.88/claim|Median: $14.00
1.0× median
59425Top 25%

Antepartum care only, 4-6 visits

$57K

650 claims · 0.3%

Your Cost: $87.05/claim|Median: $63.63
1.4× median
80061Normal range

Lipid panel

$41K

8,630 claims · 0.2%

Your Cost: $4.80/claim|Median: $8.41
0.6× median
87807Top 25%

$30K

2,498 claims · 0.2%

Your Cost: $12.02/claim|Median: $10.06
1.2× median
99212Normal range

Office/outpatient visit, low complexity

$30K

1,068 claims · 0.2%

Your Cost: $27.65/claim|Median: $25.06
1.1× median
99308Normal range

Nursing facility care, subsequent, straightforward

$29K

3,860 claims · 0.2%

Your Cost: $7.47/claim|Median: $9.79
0.8× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$26K

543 claims · 0.2%

Your Cost: $47.70/claim|Median: $40.11
1.2× median
J0561Normal range

$24K

272 claims · 0.1%

Your Cost: $88.60/claim|Median: $96.49
0.9× median
99223Normal range

Initial hospital care, per day, high complexity

$23K

331 claims · 0.1%

Your Cost: $70.43/claim|Median: $67.32
1.0× median
83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$22K

7,474 claims · 0.1%

Your Cost: $2.99/claim|Median: $5.50
0.5× median
36415Normal range

Collection of venous blood by venipuncture

$20K

27K claims · 0.1%

Your Cost: $0.76/claim|Median: $1.57
0.5× median
99307Normal range

$19K

3,298 claims · 0.1%

Your Cost: $5.88/claim|Median: $6.57
0.9× median
99318Top 5%

$19K

292 claims · 0.1%

Your Cost: $64.55/claim|Median: $15.64
4.1× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$18K

523 claims · 0.1%

Your Cost: $34.31/claim|Median: $58.55
0.6× median
J0585Normal range

Injection, onabotulinumtoxinA, 1 unit

$18K

157 claims · 0.1%

Your Cost: $112.09/claim|Median: $470.36
0.2× median
99220Top 25%

$17K

154 claims · 0.1%

Your Cost: $108.41/claim|Median: $73.56
1.5× median
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