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Provider 1104917954

NPI: 1104917954Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$12.6M

$12,577,274

Total Claims

483K

Beneficiaries

428K

1.1 claims/patient

Avg Cost/Claim

$26

Monthly Spending Trend

Yearly Spending

2018
$1.3M
+39%
2019
$1.7M
-22%
2020
$1.4M
+20%
2021
$1.6M
+22%
2022
$2.0M
+14%
2023
$2.3M
-1%
2024
$2.3M

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 37% of total spending.

99213Top 25%

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

$4.6M

83K claims · 36.9%

Your Cost: $56.03/claim|Median: $37.81
1.5× median
99214Top 25%

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

$1.5M

19K claims · 11.9%

Your Cost: $78.57/claim|Median: $53.41
1.5× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$1.4M

21K claims · 11.1%

Your Cost: $66.83/claim|Median: $69.35
1.0× median
99392Normal range

Preventive medicine, established patient, age 1-4

$1.3M

18K claims · 10.1%

Your Cost: $71.97/claim|Median: $75.18
1.0× median
99393Normal range

Preventive medicine, established patient, age 5-11

$661K

8,880 claims · 5.3%

Your Cost: $74.47/claim|Median: $74.82
1.0× median
99212Normal range

Office/outpatient visit, low complexity

$493K

15K claims · 3.9%

Your Cost: $33.85/claim|Median: $25.06
1.4× median
90670Top 10%

$267K

10K claims · 2.1%

Your Cost: $25.96/claim|Median: $5.94
4.4× median
99394Normal range

Preventive medicine, established patient, age 12-17

$242K

3,008 claims · 1.9%

Your Cost: $80.34/claim|Median: $80.15
1.0× median
87804Normal range

Influenza virus detection, rapid test

$229K

19K claims · 1.8%

Your Cost: $12.02/claim|Median: $12.59
1.0× median
90700Top 25%

$209K

18K claims · 1.7%

Your Cost: $11.72/claim|Median: $4.56
2.6× median
90677Top 25%

$185K

2,106 claims · 1.5%

Your Cost: $87.72/claim|Median: $12.96
6.8× median
87426Normal range

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

$164K

6,058 claims · 1.3%

Your Cost: $27.02/claim|Median: $30.04
0.9× median
90713Top 25%

Poliovirus vaccine (IPV)

$149K

12K claims · 1.2%

Your Cost: $12.45/claim|Median: $5.41
2.3× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$147K

54K claims · 1.2%

Your Cost: $2.73/claim|Median: $17.85
0.2× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$133K

13K claims · 1.1%

Your Cost: $10.62/claim|Median: $7.18
1.5× median
90648Top 25%

$128K

12K claims · 1.0%

Your Cost: $10.39/claim|Median: $4.08
2.5× median
90680Top 10%

$117K

6,075 claims · 0.9%

Your Cost: $19.21/claim|Median: $5.58
3.4× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$117K

9,682 claims · 0.9%

Your Cost: $12.04/claim|Median: $11.48
1.0× median
99173Normal range

$52K

30K claims · 0.4%

Your Cost: $1.74/claim|Median: $2.16
0.8× median
90651Top 25%

HPV vaccine, 9-valent

$50K

1,207 claims · 0.4%

Your Cost: $41.61/claim|Median: $8.93
4.7× median
90744Top 25%

$47K

3,968 claims · 0.4%

Your Cost: $11.77/claim|Median: $5.00
2.4× median
90716Top 10%

$46K

1,838 claims · 0.4%

Your Cost: $24.99/claim|Median: $6.18
4.0× median
90619Top 10%

$42K

696 claims · 0.3%

Your Cost: $60.09/claim|Median: $8.36
7.2× median
90633Top 25%

$32K

2,632 claims · 0.3%

Your Cost: $12.24/claim|Median: $3.56
3.4× median
90707Top 25%

MMR vaccine

$32K

1,739 claims · 0.3%

Your Cost: $18.50/claim|Median: $5.76
3.2× median
85014Normal range

$32K

14K claims · 0.3%

Your Cost: $2.21/claim|Median: $1.38
1.6× median
90461Normal range

Immunization admin, additional vaccine, counseling

$30K

25K claims · 0.2%

Your Cost: $1.20/claim|Median: $6.93
0.2× median
99381Normal range

Preventive visit, new patient, infant (<1 yr)

$26K

398 claims · 0.2%

Your Cost: $65.14/claim|Median: $73.46
0.9× median
96161Normal range

$23K

27K claims · 0.2%

Your Cost: $0.88/claim|Median: $2.49
0.4× median
81002Top 25%

Urinalysis, non-automated without microscopy

$15K

5,769 claims · 0.1%

Your Cost: $2.68/claim|Median: $2.00
1.3× median
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