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Provider 1114472891

NPI: 1114472891Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$16.6M

$16,573,825

Total Claims

44K

Beneficiaries

36K

1.2 claims/patient

Avg Cost/Claim

$373

Monthly Spending Trend

Yearly Spending

2018
$1.5M
+25%
2019
$1.9M
-9%
2020
$1.7M
+74%
2021
$3.0M
+6%
2022
$3.2M
-14%
2023
$2.7M
-5%
2024
$2.6M

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 92% of total spending.

99213Top 1%

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

$15.2M

35K claims · 91.9%

Your Cost: $438.74/claim|Median: $37.81
11.6× median
90837Top 1%

Psychotherapy, 60 minutes

$721K

1,479 claims · 4.4%

Your Cost: $487.66/claim|Median: $85.66
5.7× median
99211Top 1%

Office/outpatient visit, minimal complexity

$159K

363 claims · 1.0%

Your Cost: $438.14/claim|Median: $12.93
33.9× median
D1206Top 1%

Topical application of fluoride varnish

$153K

223 claims · 0.9%

Your Cost: $686.76/claim|Median: $18.12
37.9× median
99214Top 25%

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

$129K

1,380 claims · 0.8%

Your Cost: $93.64/claim|Median: $53.41
1.8× median
D0140Top 1%

Limited oral evaluation, problem focused

$95K

147 claims · 0.6%

Your Cost: $645.53/claim|Median: $27.07
23.8× median
D1110Top 1%

Prophylaxis, adult cleaning

$10K

18 claims · 0.1%

Your Cost: $568.89/claim|Median: $43.38
13.1× median
D1120Top 1%

Prophylaxis, adult

$10K

17 claims · 0.1%

Your Cost: $564.71/claim|Median: $33.86
16.7× median
4270Top 1%

$9K

245 claims · 0.1%

Your Cost: $38.34/claim|Median: $38.34
1.0× median
Q3014Top 10%

Telehealth originating site facility fee

$8K

254 claims · 0.0%

Your Cost: $30.42/claim|Median: $15.37
2.0× median
42700Normal range

$6K

15 claims · 0.0%

Your Cost: $370.07/claim|Median: $361.34
1.0× median
90471Normal range

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

$5K

397 claims · 0.0%

Your Cost: $11.54/claim|Median: $9.80
1.2× median
0012ANormal range

COVID-19 vaccine admin, Moderna, 2nd dose

$4K

252 claims · 0.0%

Your Cost: $17.79/claim|Median: $33.85
0.5× median
0011ANormal range

COVID-19 vaccine admin, Moderna, 1st dose

$4K

231 claims · 0.0%

Your Cost: $19.26/claim|Median: $25.93
0.7× median
99215Top 25%

Office/outpatient visit, high complexity

$4K

33 claims · 0.0%

Your Cost: $133.50/claim|Median: $74.09
1.8× median
99203Top 25%

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

$3K

32 claims · 0.0%

Your Cost: $93.62/claim|Median: $57.85
1.6× median
0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$3K

118 claims · 0.0%

Your Cost: $22.09/claim|Median: $36.70
0.6× median
0031ANormal range

COVID-19 vaccine admin, J&J, single dose

$2K

125 claims · 0.0%

Your Cost: $16.68/claim|Median: $32.49
0.5× median
80048Normal range

Basic metabolic panel

$2K

634 claims · 0.0%

Your Cost: $3.08/claim|Median: $5.78
0.5× median
0001ANormal range

COVID-19 vaccine admin, Pfizer, 1st dose

$2K

102 claims · 0.0%

Your Cost: $16.36/claim|Median: $33.72
0.5× median
80076Normal range

Hepatic function panel

$2K

380 claims · 0.0%

Your Cost: $4.18/claim|Median: $4.59
0.9× median
0064ATop 10%

$2K

29 claims · 0.0%

Your Cost: $53.82/claim|Median: $34.17
1.6× median
83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$1K

318 claims · 0.0%

Your Cost: $4.44/claim|Median: $5.50
0.8× median
85025Normal range

Complete blood count (CBC) with differential, automated

$1K

409 claims · 0.0%

Your Cost: $3.13/claim|Median: $4.71
0.7× median
36415Normal range

Collection of venous blood by venipuncture

$1K

1,101 claims · 0.0%

Your Cost: $1.16/claim|Median: $1.57
0.7× median
H0016Normal range

Alcohol or drug abuse services, prenatal

$1K

17 claims · 0.0%

Your Cost: $68.93/claim|Median: $182.66
0.4× median
80061Normal range

Lipid panel

$1K

123 claims · 0.0%

Your Cost: $9.07/claim|Median: $8.41
1.1× median
91320Normal range

$1K

18 claims · 0.0%

Your Cost: $57.86/claim|Median: $72.65
0.8× median
0004ATop 10%

$631

12 claims · 0.0%

Your Cost: $52.54/claim|Median: $35.62
1.5× median
90688Normal range

$572

241 claims · 0.0%

Your Cost: $2.37/claim|Median: $9.00
0.3× median
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