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Provider 1073970687

NPI: 1073970687Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$14.3M

$14,335,563

Total Claims

124K

Beneficiaries

117K

1.1 claims/patient

Avg Cost/Claim

$116

Monthly Spending Trend

Yearly Spending

2018
$983K
+47%
2019
$1.4M
+0%
2020
$1.5M
-7%
2021
$1.4M
+87%
2022
$2.5M
+71%
2023
$4.3M
-49%
2024
$2.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (J0178 (Injection, aflibercept, 1 mg)) accounts for 19% of total spending.

J0178Top 10%

Injection, aflibercept, 1 mg

$2.7M

1,723 claims · 19.0%

Your Cost: $1,578.67/claim|Median: $730.09
2.2× median
67028Top 5%

Intravitreal injection of a pharmacologic agent

$2.6M

8,566 claims · 18.0%

Your Cost: $301.00/claim|Median: $58.82
5.1× median
J2777Top 5%

$2.4M

1,377 claims · 16.9%

Your Cost: $1,755.92/claim|Median: $858.80
2.0× median
66984Top 10%

Extracapsular cataract removal with IOL insertion

$1.9M

2,288 claims · 12.9%

Your Cost: $811.00/claim|Median: $268.70
3.0× median
68761Top 25%

$651K

5,794 claims · 4.5%

Your Cost: $112.34/claim|Median: $60.32
1.9× median
99214Normal range

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

$572K

14K claims · 4.0%

Your Cost: $40.71/claim|Median: $53.41
0.8× median
92250Normal range

Fundus photography with interpretation and report

$569K

15K claims · 4.0%

Your Cost: $38.54/claim|Median: $27.95
1.4× median
92134Top 25%

$436K

14K claims · 3.0%

Your Cost: $30.25/claim|Median: $15.46
2.0× median
99204Normal range

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

$418K

5,242 claims · 2.9%

Your Cost: $79.68/claim|Median: $84.03
0.9× median
J9035Top 25%

Injection, bevacizumab, 10 mg

$282K

4,095 claims · 2.0%

Your Cost: $68.82/claim|Median: $43.71
1.6× median
67228Normal range

$276K

947 claims · 1.9%

Your Cost: $291.41/claim|Median: $256.67
1.1× median
99213Normal range

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

$269K

10K claims · 1.9%

Your Cost: $26.46/claim|Median: $37.81
0.7× median
92133Top 25%

$239K

7,764 claims · 1.7%

Your Cost: $30.76/claim|Median: $19.09
1.6× median
92083Normal range

Visual field exam, extended testing, bilateral

$162K

5,861 claims · 1.1%

Your Cost: $27.68/claim|Median: $29.82
0.9× median
92014Normal range

Ophthalmological exam, comprehensive, established patient

$154K

4,311 claims · 1.1%

Your Cost: $35.76/claim|Median: $47.08
0.8× median
92012Normal range

Ophthalmological exam, intermediate, established patient

$151K

4,626 claims · 1.1%

Your Cost: $32.62/claim|Median: $38.23
0.9× median
92235Top 25%

$123K

1,642 claims · 0.9%

Your Cost: $75.02/claim|Median: $42.71
1.8× median
92136Top 10%

$117K

2,650 claims · 0.8%

Your Cost: $44.09/claim|Median: $18.31
2.4× median
99244Normal range

Office or other outpatient consultation, moderate complexity

$52K

554 claims · 0.4%

Your Cost: $93.50/claim|Median: $121.58
0.8× median
76514Top 25%

$50K

4,863 claims · 0.3%

Your Cost: $10.30/claim|Median: $6.67
1.5× median
99203Normal range

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

$49K

733 claims · 0.3%

Your Cost: $67.41/claim|Median: $57.85
1.2× median
92020Normal range

$46K

2,883 claims · 0.3%

Your Cost: $15.80/claim|Median: $12.46
1.3× median
66821Top 25%

$32K

211 claims · 0.2%

Your Cost: $149.96/claim|Median: $83.06
1.8× median
92015Normal range

Determination of refractive state

$20K

1,406 claims · 0.1%

Your Cost: $14.51/claim|Median: $10.36
1.4× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$19K

201 claims · 0.1%

Your Cost: $93.70/claim|Median: $111.09
0.8× median
92025Top 25%

$16K

600 claims · 0.1%

Your Cost: $27.33/claim|Median: $17.08
1.6× median
99243Normal range

Office or other outpatient consultation, low complexity

$13K

198 claims · 0.1%

Your Cost: $67.00/claim|Median: $82.43
0.8× median
67210Top 25%

$11K

32 claims · 0.1%

Your Cost: $358.20/claim|Median: $249.34
1.4× median
99212Normal range

Office/outpatient visit, low complexity

$10K

542 claims · 0.1%

Your Cost: $19.00/claim|Median: $25.06
0.8× median
99215Normal range

Office/outpatient visit, high complexity

$10K

168 claims · 0.1%

Your Cost: $60.78/claim|Median: $74.09
0.8× median
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