Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

⚖️ Compare🖨️ Print Report

Provider 1063488179

NPI: 1063488179Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$7.8M

$7,774,453

Total Claims

131K

Beneficiaries

125K

1.1 claims/patient

Avg Cost/Claim

$59

Monthly Spending Trend

Yearly Spending

2018
$606K
+11%
2019
$670K
+49%
2020
$1.0M
+53%
2021
$1.5M
-8%
2022
$1.4M
+8%
2023
$1.5M
-31%
2024
$1.0M

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.

99214Top 10%

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

$3.3M

31K claims · 42.2%

Your Cost: $107.50/claim|Median: $53.41
2.0× median
99213Top 10%

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

$2.7M

36K claims · 34.7%

Your Cost: $75.26/claim|Median: $37.81
2.0× median
88305Top 25%

Surgical pathology, gross and microscopic examination

$230K

2,932 claims · 3.0%

Your Cost: $78.28/claim|Median: $35.80
2.2× median
99204Top 5%

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

$210K

1,285 claims · 2.7%

Your Cost: $163.06/claim|Median: $84.03
1.9× median
99203Top 10%

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

$173K

1,590 claims · 2.2%

Your Cost: $108.53/claim|Median: $57.85
1.9× median
92014Top 5%

Ophthalmological exam, comprehensive, established patient

$136K

1,188 claims · 1.7%

Your Cost: $114.40/claim|Median: $47.08
2.4× median
76830Top 25%

Ultrasound, transvaginal

$132K

1,483 claims · 1.7%

Your Cost: $88.81/claim|Median: $57.47
1.5× median
92250Normal range

Fundus photography with interpretation and report

$104K

2,749 claims · 1.3%

Your Cost: $37.77/claim|Median: $27.95
1.4× median
00811Top 25%

$85K

891 claims · 1.1%

Your Cost: $95.05/claim|Median: $56.15
1.7× median
17110Top 10%

Destruction of benign lesions, up to fourteen

$74K

681 claims · 1.0%

Your Cost: $108.87/claim|Median: $59.25
1.8× median
99202Top 25%

Office/outpatient visit, new patient, low complexity

$70K

936 claims · 0.9%

Your Cost: $74.72/claim|Median: $40.11
1.9× median
A4550Top 5%

$64K

212 claims · 0.8%

Your Cost: $300.00/claim|Median: $4.85
61.9× median
99396Top 25%

Preventive medicine, established patient, age 40-64

$60K

529 claims · 0.8%

Your Cost: $112.89/claim|Median: $76.06
1.5× median
43239Top 25%

Upper GI endoscopy with biopsy

$49K

168 claims · 0.6%

Your Cost: $290.51/claim|Median: $151.68
1.9× median
88342Normal range

$39K

1,113 claims · 0.5%

Your Cost: $35.30/claim|Median: $23.66
1.5× median
36415Normal range

Collection of venous blood by venipuncture

$38K

15K claims · 0.5%

Your Cost: $2.53/claim|Median: $1.57
1.6× median
99395Top 25%

Preventive medicine, established patient, age 18-39

$36K

320 claims · 0.5%

Your Cost: $113.35/claim|Median: $72.71
1.6× median
92012Top 5%

Ophthalmological exam, intermediate, established patient

$35K

417 claims · 0.4%

Your Cost: $83.09/claim|Median: $38.23
2.2× median
99212Top 25%

Office/outpatient visit, low complexity

$33K

605 claims · 0.4%

Your Cost: $54.66/claim|Median: $25.06
2.2× median
99454Top 25%

$26K

916 claims · 0.3%

Your Cost: $28.55/claim|Median: $9.15
3.1× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$24K

584 claims · 0.3%

Your Cost: $41.93/claim|Median: $39.70
1.1× median
45380Normal range

Colonoscopy with biopsy

$21K

73 claims · 0.3%

Your Cost: $292.84/claim|Median: $200.68
1.5× median
90471Normal range

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

$21K

1,472 claims · 0.3%

Your Cost: $14.18/claim|Median: $9.80
1.4× median
92004Top 5%

Ophthalmological exam, comprehensive, new patient

$21K

153 claims · 0.3%

Your Cost: $135.43/claim|Median: $59.72
2.3× median
90682Top 10%

$19K

322 claims · 0.2%

Your Cost: $59.29/claim|Median: $34.72
1.7× median
99457Normal range

$19K

2,224 claims · 0.2%

Your Cost: $8.40/claim|Median: $6.05
1.4× median
11102Top 25%

$12K

132 claims · 0.2%

Your Cost: $94.43/claim|Median: $48.69
1.9× median
45385Normal range

Colonoscopy with polyp removal, snare technique

$11K

29 claims · 0.1%

Your Cost: $376.20/claim|Median: $255.17
1.5× median
00731Normal range

$11K

117 claims · 0.1%

Your Cost: $89.76/claim|Median: $64.75
1.4× median
92083Top 5%

Visual field exam, extended testing, bilateral

$5K

90 claims · 0.1%

Your Cost: $58.25/claim|Median: $29.82
2.0× median
← All providersHow we detect fraud →