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

⚖️ Compare🖨️ Print Report

Provider 1154355220

NPI: 1154355220Share
Active Billing Period:2018-01→2024-12(81 months)

Total Paid

$11.5M

$11,462,118

Total Claims

263K

Beneficiaries

236K

1.1 claims/patient

Avg Cost/Claim

$44

Monthly Spending Trend

Yearly Spending

2018
$38K
-59%
2019
$15K
+4289%
2020
$678K
+390%
2021
$3.3M
-11%
2022
$2.9M
-19%
2023
$2.4M
-13%
2024
$2.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99215 (Office/outpatient visit, high complexity)) accounts for 22% of total spending.

99215Normal range

Office/outpatient visit, high complexity

$2.5M

30K claims · 22.1%

Your Cost: $84.37/claim|Median: $74.09
1.1× median
99213Normal range

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

$1.8M

39K claims · 15.7%

Your Cost: $45.93/claim|Median: $37.81
1.2× median
99214Normal range

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

$915K

15K claims · 8.0%

Your Cost: $63.09/claim|Median: $53.41
1.2× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$784K

15K claims · 6.8%

Your Cost: $51.69/claim|Median: $58.55
0.9× median
76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$689K

5,086 claims · 6.0%

Your Cost: $135.52/claim|Median: $106.79
1.3× median
76801Normal range

Ultrasound, pregnant uterus, single fetus, first trimester

$423K

6,120 claims · 3.7%

Your Cost: $69.18/claim|Median: $58.16
1.2× median
G0101Top 5%

Cervical/vaginal cancer screening; pelvic exam

$399K

8,089 claims · 3.5%

Your Cost: $49.33/claim|Median: $21.28
2.3× median
Q0091Top 1%

$368K

6,786 claims · 3.2%

Your Cost: $54.18/claim|Median: $11.15
4.9× median
76813Normal range

Ultrasound for fetal nuchal translucency measurement

$314K

4,987 claims · 2.7%

Your Cost: $62.95/claim|Median: $70.87
0.9× median
59025Normal range

Fetal non-stress test

$243K

13K claims · 2.1%

Your Cost: $18.21/claim|Median: $26.45
0.7× median
76815Normal range

Ultrasound, pregnant uterus, limited

$238K

6,399 claims · 2.1%

Your Cost: $37.25/claim|Median: $36.79
1.0× median
76817Normal range

Ultrasound, pregnant uterus, transvaginal

$237K

4,059 claims · 2.1%

Your Cost: $58.36/claim|Median: $47.65
1.2× median
59409Top 5%

Vaginal delivery only

$231K

145 claims · 2.0%

Your Cost: $1,591.65/claim|Median: $619.91
2.6× median
T1001Top 25%

Nursing assessment/evaluation, per visit

$224K

1,869 claims · 2.0%

Your Cost: $119.63/claim|Median: $49.05
2.4× median
76818Normal range

$217K

3,391 claims · 1.9%

Your Cost: $63.87/claim|Median: $68.15
0.9× median
76805Normal range

Ultrasound, pregnant uterus, complete, single fetus

$182K

3,881 claims · 1.6%

Your Cost: $46.91/claim|Median: $74.78
0.6× median
76819Normal range

Fetal biophysical profile with non-stress test

$177K

3,996 claims · 1.5%

Your Cost: $44.41/claim|Median: $49.45
0.9× median
99212Normal range

Office/outpatient visit, low complexity

$176K

4,868 claims · 1.5%

Your Cost: $36.17/claim|Median: $25.06
1.4× median
59430Normal range

$108K

1,061 claims · 0.9%

Your Cost: $101.40/claim|Median: $80.32
1.3× median
J7307Normal range

Etonogestrel implant system, including implant and supplies

$104K

252 claims · 0.9%

Your Cost: $414.08/claim|Median: $786.43
0.5× median
54150Normal range

$90K

895 claims · 0.8%

Your Cost: $100.17/claim|Median: $84.60
1.2× median
76820Normal range

$86K

2,595 claims · 0.8%

Your Cost: $33.28/claim|Median: $31.79
1.0× median
99429Top 5%

$84K

626 claims · 0.7%

Your Cost: $134.45/claim|Median: $28.58
4.7× median
81025Normal range

Urine pregnancy test

$80K

16K claims · 0.7%

Your Cost: $5.17/claim|Median: $4.81
1.1× median
90651Top 10%

HPV vaccine, 9-valent

$71K

1,311 claims · 0.6%

Your Cost: $53.85/claim|Median: $8.93
6.0× median
96372Top 25%

Therapeutic injection, subcutaneous/intramuscular

$62K

4,022 claims · 0.5%

Your Cost: $15.33/claim|Median: $9.56
1.6× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$61K

1,347 claims · 0.5%

Your Cost: $45.50/claim|Median: $40.11
1.1× median
36415Top 25%

Collection of venous blood by venipuncture

$57K

15K claims · 0.5%

Your Cost: $3.80/claim|Median: $1.57
2.4× median
99242Normal range

Office consultation, low complexity

$52K

869 claims · 0.5%

Your Cost: $60.07/claim|Median: $57.97
1.0× median
99211Top 10%

Office/outpatient visit, minimal complexity

$47K

945 claims · 0.4%

Your Cost: $49.74/claim|Median: $12.93
3.8× median
← All providersHow we detect fraud →