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Provider 1053612911

NPI: 1053612911Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$11.1M

$11,100,739

Total Claims

303K

Beneficiaries

268K

1.1 claims/patient

Avg Cost/Claim

$37

Monthly Spending Trend

Yearly Spending

2018
$1.8M
+4%
2019
$1.9M
+0%
2020
$1.9M
-15%
2021
$1.6M
-21%
2022
$1.3M
+10%
2023
$1.4M
-19%
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 32% of total spending.

99213Top 25%

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

$3.5M

53K claims · 31.9%

Your Cost: $66.33/claim|Median: $37.81
1.8× median
99392Top 10%

Preventive medicine, established patient, age 1-4

$1.0M

9,459 claims · 9.2%

Your Cost: $108.04/claim|Median: $75.18
1.4× median
99391Top 10%

Preventive medicine, established patient, infant (under 1)

$927K

9,235 claims · 8.3%

Your Cost: $100.36/claim|Median: $69.35
1.4× median
99393Top 25%

Preventive medicine, established patient, age 5-11

$886K

8,501 claims · 8.0%

Your Cost: $104.20/claim|Median: $74.82
1.4× median
90460Top 25%

Immunization administration, first vaccine/toxoid, with counseling

$882K

24K claims · 7.9%

Your Cost: $37.43/claim|Median: $17.85
2.1× median
99214Top 25%

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

$674K

7,457 claims · 6.1%

Your Cost: $90.37/claim|Median: $53.41
1.7× median
99394Top 25%

Preventive medicine, established patient, age 12-17

$541K

4,848 claims · 4.9%

Your Cost: $111.62/claim|Median: $80.15
1.4× median
96110Top 25%

Developmental screening, per standardized instrument

$383K

18K claims · 3.4%

Your Cost: $21.24/claim|Median: $9.10
2.3× median
96127Top 5%

Brief emotional/behavioral assessment, per standardized instrument

$300K

14K claims · 2.7%

Your Cost: $21.77/claim|Median: $3.67
5.9× median
99177Top 10%

$299K

18K claims · 2.7%

Your Cost: $16.97/claim|Median: $3.74
4.5× median
92587Normal range

$290K

13K claims · 2.6%

Your Cost: $21.55/claim|Median: $19.24
1.1× median
96160Top 5%

Patient-focused health risk assessment

$270K

14K claims · 2.4%

Your Cost: $18.93/claim|Median: $2.10
9.0× median
96161Top 5%

$251K

16K claims · 2.3%

Your Cost: $15.71/claim|Median: $2.49
6.3× median
87636Normal range

Respiratory virus detection, 6-11 targets, nucleic acid

$241K

1,974 claims · 2.2%

Your Cost: $121.93/claim|Median: $97.61
1.2× median
90471Top 10%

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

$144K

7,404 claims · 1.3%

Your Cost: $19.43/claim|Median: $9.80
2.0× median
90472Top 10%

Immunization administration, each additional vaccine

$67K

1,953 claims · 0.6%

Your Cost: $34.19/claim|Median: $11.79
2.9× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$53K

5,858 claims · 0.5%

Your Cost: $8.97/claim|Median: $11.48
0.8× median
92551Normal range

Screening audiometry, pure tone, air only

$40K

7,383 claims · 0.4%

Your Cost: $5.48/claim|Median: $6.61
0.8× median
99203Top 10%

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

$39K

376 claims · 0.3%

Your Cost: $102.52/claim|Median: $57.85
1.8× median
87502Normal range

Influenza virus detection, reverse transcription, amplified probe

$35K

533 claims · 0.3%

Your Cost: $66.10/claim|Median: $65.64
1.0× median
36416Top 25%

$28K

9,288 claims · 0.2%

Your Cost: $2.97/claim|Median: $1.31
2.3× median
92558Top 25%

$22K

1,059 claims · 0.2%

Your Cost: $20.97/claim|Median: $6.67
3.1× median
99381Normal range

Preventive visit, new patient, infant (<1 yr)

$20K

246 claims · 0.2%

Your Cost: $82.72/claim|Median: $73.46
1.1× median
99204Top 5%

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

$16K

95 claims · 0.1%

Your Cost: $166.22/claim|Median: $84.03
2.0× median
99188Top 25%

$14K

656 claims · 0.1%

Your Cost: $21.12/claim|Median: $12.80
1.7× median
83655Normal range

$13K

1,282 claims · 0.1%

Your Cost: $10.22/claim|Median: $10.49
1.0× median
92015Top 10%

Determination of refractive state

$9K

349 claims · 0.1%

Your Cost: $25.22/claim|Median: $10.36
2.4× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$8K

193 claims · 0.1%

Your Cost: $39.63/claim|Median: $62.48
0.6× median
99383Top 25%

Preventive visit, new patient, late childhood (5-11 yr)

$7K

71 claims · 0.1%

Your Cost: $105.35/claim|Median: $81.92
1.3× median
90651Normal range

HPV vaccine, 9-valent

$7K

1,363 claims · 0.1%

Your Cost: $5.35/claim|Median: $8.93
0.6× median
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