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Provider 1053955120

NPI: 1053955120Share
Active Billing Period:2019-01→2022-06(36 months)
Billing appears to have stoppedLast active: 2022-06

Total Paid

$8.0M

$8,044,007

Total Claims

61K

Beneficiaries

55K

1.1 claims/patient

Avg Cost/Claim

$133

Monthly Spending Trend

Yearly Spending

2019
$68K
+4069%
2020
$2.8M
+23%
2021
$3.5M
-52%
2022
$1.7M

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 36% of total spending.

99213Top 1%

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

$2.9M

15K claims · 35.8%

Your Cost: $186.61/claim|Median: $37.81
4.9× median
99214Top 5%

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

$1.3M

8,253 claims · 16.7%

Your Cost: $163.11/claim|Median: $53.41
3.1× median
D0140Top 1%

Limited oral evaluation, problem focused

$1.3M

7,448 claims · 16.6%

Your Cost: $179.63/claim|Median: $27.07
6.6× median
D9999Top 25%

Unspecified adjunctive procedure, by report

$775K

3,805 claims · 9.6%

Your Cost: $203.70/claim|Median: $37.60
5.4× median
90832Top 5%

Psychotherapy, 30 minutes

$409K

2,194 claims · 5.1%

Your Cost: $186.23/claim|Median: $41.28
4.5× median
98968Top 5%

$356K

2,197 claims · 4.4%

Your Cost: $161.87/claim|Median: $28.39
5.7× median
99212Top 5%

Office/outpatient visit, low complexity

$190K

1,008 claims · 2.4%

Your Cost: $188.87/claim|Median: $25.06
7.5× median
99393Top 5%

Preventive medicine, established patient, age 5-11

$155K

791 claims · 1.9%

Your Cost: $196.44/claim|Median: $74.82
2.6× median
99392Top 1%

Preventive medicine, established patient, age 1-4

$118K

542 claims · 1.5%

Your Cost: $218.59/claim|Median: $75.18
2.9× median
99394Top 5%

Preventive medicine, established patient, age 12-17

$98K

517 claims · 1.2%

Your Cost: $189.94/claim|Median: $80.15
2.4× median
99391Top 1%

Preventive medicine, established patient, infant (under 1)

$96K

441 claims · 1.2%

Your Cost: $218.13/claim|Median: $69.35
3.1× median
G0467Top 25%

Federally qualified health center visit, mental health

$52K

1,466 claims · 0.6%

Your Cost: $35.33/claim|Median: $21.91
1.6× median
G0101Top 1%

Cervical/vaginal cancer screening; pelvic exam

$42K

222 claims · 0.5%

Your Cost: $188.21/claim|Median: $21.28
8.8× median
0012ATop 10%

COVID-19 vaccine admin, Moderna, 2nd dose

$26K

477 claims · 0.3%

Your Cost: $54.80/claim|Median: $33.85
1.6× median
99203Top 5%

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

$26K

180 claims · 0.3%

Your Cost: $144.59/claim|Median: $57.85
2.5× median
0001ANormal range

COVID-19 vaccine admin, Pfizer, 1st dose

$20K

590 claims · 0.2%

Your Cost: $33.46/claim|Median: $33.72
1.0× median
0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$20K

567 claims · 0.2%

Your Cost: $34.63/claim|Median: $36.70
0.9× median
0011ANormal range

COVID-19 vaccine admin, Moderna, 1st dose

$13K

509 claims · 0.2%

Your Cost: $26.51/claim|Median: $25.93
1.0× median
90791Top 10%

Psychiatric diagnostic evaluation

$12K

68 claims · 0.1%

Your Cost: $174.15/claim|Median: $99.21
1.8× median
90834Top 5%

Psychotherapy, 45 minutes

$11K

54 claims · 0.1%

Your Cost: $197.68/claim|Median: $63.65
3.1× median
99384Top 5%

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

$10K

51 claims · 0.1%

Your Cost: $199.82/claim|Median: $83.63
2.4× median
0071ANormal range

$10K

279 claims · 0.1%

Your Cost: $35.34/claim|Median: $38.71
0.9× median
0072ANormal range

$8K

216 claims · 0.1%

Your Cost: $36.80/claim|Median: $39.57
0.9× median
99383Top 1%

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

$8K

34 claims · 0.1%

Your Cost: $233.22/claim|Median: $81.92
2.8× median
0004ANormal range

$7K

219 claims · 0.1%

Your Cost: $32.68/claim|Median: $35.62
0.9× median
98967Top 10%

$7K

66 claims · 0.1%

Your Cost: $98.56/claim|Median: $18.97
5.2× median
0064ANormal range

$5K

152 claims · 0.1%

Your Cost: $31.10/claim|Median: $34.17
0.9× median
0031ANormal range

COVID-19 vaccine admin, J&J, single dose

$4K

128 claims · 0.0%

Your Cost: $29.72/claim|Median: $32.49
0.9× median
99395Top 1%

Preventive medicine, established patient, age 18-39

$3K

12 claims · 0.0%

Your Cost: $238.12/claim|Median: $72.71
3.3× median
87811Normal range

SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-read

$1K

87 claims · 0.0%

Your Cost: $15.70/claim|Median: $30.53
0.5× median
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