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Provider 1104067636

NPI: 1104067636Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$12.8M

$12,834,005

Total Claims

214K

Beneficiaries

181K

1.2 claims/patient

Avg Cost/Claim

$60

Monthly Spending Trend

Yearly Spending

2018
$905K
+7%
2019
$970K
+73%
2020
$1.7M
+52%
2021
$2.5M
-17%
2022
$2.1M
+23%
2023
$2.6M
-22%
2024
$2.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 87% of total spending.

T1015Top 25%

Clinic visit/encounter, all-inclusive

$11.1M

49K claims · 86.8%

Your Cost: $228.08/claim|Median: $121.16
1.9× median
99213Normal range

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

$588K

43K claims · 4.6%

Your Cost: $13.83/claim|Median: $37.81
0.4× median
99214Normal range

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

$383K

17K claims · 3.0%

Your Cost: $22.19/claim|Median: $53.41
0.4× median
87428Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay, each

$249K

7,275 claims · 1.9%

Your Cost: $34.18/claim|Median: $39.63
0.9× median
G0467Top 25%

Federally qualified health center visit, mental health

$114K

2,508 claims · 0.9%

Your Cost: $45.55/claim|Median: $21.91
2.1× median
99212Normal range

Office/outpatient visit, low complexity

$83K

9,101 claims · 0.6%

Your Cost: $9.14/claim|Median: $25.06
0.4× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$32K

4,601 claims · 0.3%

Your Cost: $6.97/claim|Median: $11.48
0.6× median
87426Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$26K

3,430 claims · 0.2%

Your Cost: $7.68/claim|Median: $30.04
0.3× median
G0470Normal range

Chronic care management services, FQHC/RHC

$26K

517 claims · 0.2%

Your Cost: $49.85/claim|Median: $45.95
1.1× median
90837Normal range

Psychotherapy, 60 minutes

$19K

414 claims · 0.1%

Your Cost: $46.03/claim|Median: $85.66
0.5× median
99393Normal range

Preventive medicine, established patient, age 5-11

$19K

537 claims · 0.1%

Your Cost: $34.59/claim|Median: $74.82
0.5× median
99394Normal range

Preventive medicine, established patient, age 12-17

$18K

415 claims · 0.1%

Your Cost: $43.45/claim|Median: $80.15
0.5× median
85018Top 10%

$18K

4,268 claims · 0.1%

Your Cost: $4.21/claim|Median: $1.71
2.5× median
92551Normal range

Screening audiometry, pure tone, air only

$17K

2,380 claims · 0.1%

Your Cost: $7.33/claim|Median: $6.61
1.1× median
H1001Normal range

$16K

283 claims · 0.1%

Your Cost: $57.12/claim|Median: $60.48
0.9× median
87502Normal range

Influenza virus detection, reverse transcription, amplified probe

$16K

767 claims · 0.1%

Your Cost: $20.37/claim|Median: $65.64
0.3× median
99395Top 25%

Preventive medicine, established patient, age 18-39

$6K

57 claims · 0.0%

Your Cost: $108.49/claim|Median: $72.71
1.5× median
81003Normal range

Urinalysis, automated without microscopy

$6K

4,952 claims · 0.0%

Your Cost: $1.21/claim|Median: $1.48
0.8× median
90471Normal range

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

$6K

2,230 claims · 0.0%

Your Cost: $2.62/claim|Median: $9.80
0.3× median
99173Normal range

$6K

2,359 claims · 0.0%

Your Cost: $2.45/claim|Median: $2.16
1.1× median
81002Top 5%

Urinalysis, non-automated without microscopy

$5K

942 claims · 0.0%

Your Cost: $5.37/claim|Median: $2.00
2.7× median
87430Normal range

$5K

953 claims · 0.0%

Your Cost: $5.15/claim|Median: $9.41
0.5× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$5K

931 claims · 0.0%

Your Cost: $5.06/claim|Median: $40.11
0.1× median
82947Normal range

Blood glucose level test

$3K

1,276 claims · 0.0%

Your Cost: $2.52/claim|Median: $2.38
1.1× median
99215Normal range

Office/outpatient visit, high complexity

$3K

108 claims · 0.0%

Your Cost: $29.33/claim|Median: $74.09
0.4× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$3K

824 claims · 0.0%

Your Cost: $3.73/claim|Median: $7.18
0.5× median
82948Top 10%

$3K

357 claims · 0.0%

Your Cost: $8.36/claim|Median: $1.78
4.7× median
90834Normal range

Psychotherapy, 45 minutes

$3K

120 claims · 0.0%

Your Cost: $21.92/claim|Median: $63.65
0.3× median
99396Normal range

Preventive medicine, established patient, age 40-64

$3K

35 claims · 0.0%

Your Cost: $74.47/claim|Median: $76.06
1.0× median
90756Top 25%

Influenza virus vaccine, quadrivalent

$2K

99 claims · 0.0%

Your Cost: $23.66/claim|Median: $14.34
1.6× median
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