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

⚖️ Compare🖨️ Print Report

Provider 1093054447

NPI: 1093054447Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$8.9M

$8,910,531

Total Claims

295K

Beneficiaries

236K

1.3 claims/patient

Avg Cost/Claim

$30

Monthly Spending Trend

Yearly Spending

2018
$524K
+113%
2019
$1.1M
-14%
2020
$964K
+80%
2021
$1.7M
-5%
2022
$1.7M
+3%
2023
$1.7M
-28%
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 26% of total spending.

99213Top 25%

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

$2.3M

43K claims · 26.0%

Your Cost: $53.82/claim|Median: $37.81
1.4× median
T1015Normal range

Clinic visit/encounter, all-inclusive

$1.7M

78K claims · 19.6%

Your Cost: $22.29/claim|Median: $121.16
0.2× median
99214Normal range

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

$1.3M

19K claims · 14.5%

Your Cost: $69.82/claim|Median: $53.41
1.3× median
99392Normal range

Preventive medicine, established patient, age 1-4

$515K

6,256 claims · 5.8%

Your Cost: $82.31/claim|Median: $75.18
1.1× median
99393Normal range

Preventive medicine, established patient, age 5-11

$491K

6,015 claims · 5.5%

Your Cost: $81.55/claim|Median: $74.82
1.1× median
92014Top 25%

Ophthalmological exam, comprehensive, established patient

$401K

5,460 claims · 4.5%

Your Cost: $73.47/claim|Median: $47.08
1.6× median
90471Normal range

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

$319K

36K claims · 3.6%

Your Cost: $8.79/claim|Median: $9.80
0.9× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$314K

4,115 claims · 3.5%

Your Cost: $76.21/claim|Median: $69.35
1.1× median
99394Normal range

Preventive medicine, established patient, age 12-17

$303K

3,751 claims · 3.4%

Your Cost: $80.85/claim|Median: $80.15
1.0× median
90472Normal range

Immunization administration, each additional vaccine

$226K

14K claims · 2.5%

Your Cost: $15.65/claim|Median: $11.79
1.3× median
99212Normal range

Office/outpatient visit, low complexity

$213K

7,043 claims · 2.4%

Your Cost: $30.28/claim|Median: $25.06
1.2× median
59425Normal range

Antepartum care only, 4-6 visits

$135K

2,067 claims · 1.5%

Your Cost: $65.43/claim|Median: $63.63
1.0× median
92015Normal range

Determination of refractive state

$75K

7,121 claims · 0.8%

Your Cost: $10.47/claim|Median: $10.36
1.0× median
V2020Normal range

Frames, purchases

$42K

2,024 claims · 0.5%

Your Cost: $20.99/claim|Median: $19.33
1.1× median
V2784Top 25%

Lens, polycarbonate or equal

$34K

1,392 claims · 0.4%

Your Cost: $24.73/claim|Median: $9.50
2.6× median
99215Normal range

Office/outpatient visit, high complexity

$33K

304 claims · 0.4%

Your Cost: $107.60/claim|Median: $74.09
1.5× median
97803Normal range

Medical nutrition therapy, reassessment, group, thirty minutes

$32K

1,199 claims · 0.4%

Your Cost: $26.74/claim|Median: $24.33
1.1× median
V2103Normal range

Lens, sphere-cylinder, single vision, plus or minus 4.00

$31K

1,336 claims · 0.3%

Your Cost: $23.13/claim|Median: $18.82
1.2× median
83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$31K

5,073 claims · 0.3%

Your Cost: $6.08/claim|Median: $5.50
1.1× median
59426Normal range

Antepartum care only, high risk, additional visits

$30K

357 claims · 0.3%

Your Cost: $84.28/claim|Median: $122.30
0.7× median
G0467Normal range

Federally qualified health center visit, mental health

$28K

1,292 claims · 0.3%

Your Cost: $21.61/claim|Median: $21.91
1.0× median
97802Normal range

Medical nutrition therapy, reassessment, individual, fifteen minutes

$26K

752 claims · 0.3%

Your Cost: $34.39/claim|Median: $12.70
2.7× median
92012Top 25%

Ophthalmological exam, intermediate, established patient

$26K

452 claims · 0.3%

Your Cost: $57.04/claim|Median: $38.23
1.5× median
0012ANormal range

COVID-19 vaccine admin, Moderna, 2nd dose

$19K

569 claims · 0.2%

Your Cost: $33.42/claim|Median: $33.85
1.0× median
0011ANormal range

COVID-19 vaccine admin, Moderna, 1st dose

$17K

597 claims · 0.2%

Your Cost: $28.80/claim|Median: $25.93
1.1× median
90837Normal range

Psychotherapy, 60 minutes

$15K

206 claims · 0.2%

Your Cost: $74.81/claim|Median: $85.66
0.9× median
81025Normal range

Urine pregnancy test

$15K

2,654 claims · 0.2%

Your Cost: $5.53/claim|Median: $4.81
1.2× median
90832Normal range

Psychotherapy, 30 minutes

$14K

362 claims · 0.2%

Your Cost: $37.60/claim|Median: $41.28
0.9× median
90674Normal range

$13K

1,077 claims · 0.1%

Your Cost: $12.31/claim|Median: $15.16
0.8× median
0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$11K

320 claims · 0.1%

Your Cost: $35.70/claim|Median: $36.70
1.0× median
← All providersHow we detect fraud →