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Provider 1053489260

NPI: 1053489260Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$14.4M

$14,437,209

Total Claims

146K

Beneficiaries

100K

1.5 claims/patient

Avg Cost/Claim

$99

Monthly Spending Trend

Yearly Spending

2018
$1.3M
+36%
2019
$1.8M
+15%
2020
$2.1M
-32%
2021
$1.4M
+72%
2022
$2.5M
+15%
2023
$2.8M
-12%
2024
$2.5M

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 41% of total spending.

99213Top 1%

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

$5.9M

26K claims · 40.9%

Your Cost: $229.79/claim|Median: $37.81
6.1× median
99212Top 1%

Office/outpatient visit, low complexity

$3.8M

16K claims · 26.6%

Your Cost: $235.59/claim|Median: $25.06
9.4× median
99395Top 5%

Preventive medicine, established patient, age 18-39

$2.2M

12K claims · 15.0%

Your Cost: $182.93/claim|Median: $72.71
2.5× median
99203Top 1%

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

$1.2M

5,270 claims · 8.6%

Your Cost: $235.31/claim|Median: $57.85
4.1× median
99202Top 5%

Office/outpatient visit, new patient, low complexity

$474K

2,061 claims · 3.3%

Your Cost: $229.99/claim|Median: $40.11
5.7× median
99385Top 5%

Preventive visit, new patient, 18-39 yr

$426K

2,352 claims · 3.0%

Your Cost: $181.19/claim|Median: $76.22
2.4× median
99396Top 5%

Preventive medicine, established patient, age 40-64

$108K

669 claims · 0.7%

Your Cost: $161.31/claim|Median: $76.06
2.1× median
99394Normal range

Preventive medicine, established patient, age 12-17

$66K

820 claims · 0.5%

Your Cost: $80.27/claim|Median: $80.15
1.0× median
99384Normal range

Preventive visit, new patient, adolescent (12-17 yr)

$48K

628 claims · 0.3%

Your Cost: $76.06/claim|Median: $83.63
0.9× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$46K

28K claims · 0.3%

Your Cost: $1.64/claim|Median: $9.56
0.2× median
T2023Normal range

Community transition, waiver; per service

$28K

781 claims · 0.2%

Your Cost: $35.42/claim|Median: $300.13
0.1× median
90471Normal range

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

$23K

21K claims · 0.2%

Your Cost: $1.11/claim|Median: $9.80
0.1× median
90472Normal range

Immunization administration, each additional vaccine

$18K

12K claims · 0.1%

Your Cost: $1.50/claim|Median: $11.79
0.1× median
99393Normal range

Preventive medicine, established patient, age 5-11

$9K

255 claims · 0.1%

Your Cost: $36.12/claim|Median: $74.82
0.5× median
99214Top 1%

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

$6K

32 claims · 0.0%

Your Cost: $193.65/claim|Median: $53.41
3.6× median
90651Normal range

HPV vaccine, 9-valent

$5K

1,774 claims · 0.0%

Your Cost: $2.72/claim|Median: $8.93
0.3× median
11982Normal range

$2K

496 claims · 0.0%

Your Cost: $4.97/claim|Median: $90.51
0.1× median
T1002Normal range

RN services, per 15 minutes

$2K

444 claims · 0.0%

Your Cost: $4.41/claim|Median: $37.42
0.1× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$2K

3,956 claims · 0.0%

Your Cost: $0.45/claim|Median: $17.85
0.0× median
87491Normal range

Chlamydia detection, nucleic acid, amplified probe

$2K

263 claims · 0.0%

Your Cost: $6.73/claim|Median: $24.95
0.3× median
87591Normal range

Neisseria gonorrhoeae detection, nucleic acid, amplified probe

$2K

263 claims · 0.0%

Your Cost: $6.73/claim|Median: $23.39
0.3× median
86592Normal range

$2K

903 claims · 0.0%

Your Cost: $1.77/claim|Median: $3.35
0.5× median
57454Normal range

Colposcopy with cervical biopsy and endocervical curettage

$1K

239 claims · 0.0%

Your Cost: $5.46/claim|Median: $96.39
0.1× median
90716Normal range

$1K

181 claims · 0.0%

Your Cost: $6.09/claim|Median: $6.18
1.0× median
H0031Normal range

Mental health assessment by non-physician

$928

97 claims · 0.0%

Your Cost: $9.57/claim|Median: $96.18
0.1× median
90715Normal range

Tdap vaccine

$828

438 claims · 0.0%

Your Cost: $1.89/claim|Median: $10.32
0.2× median
99401Normal range

$824

285 claims · 0.0%

Your Cost: $2.89/claim|Median: $16.53
0.2× median
T1023Normal range

Screening to determine appropriateness of consideration for program

$723

425 claims · 0.0%

Your Cost: $1.70/claim|Median: $106.70
0.0× median
90474Normal range

$595

650 claims · 0.0%

Your Cost: $0.92/claim|Median: $8.42
0.1× median
97802Normal range

Medical nutrition therapy, reassessment, individual, fifteen minutes

$571

107 claims · 0.0%

Your Cost: $5.34/claim|Median: $12.70
0.4× median
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