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

⚖️ Compare🖨️ Print Report

Provider 1154488393

NPI: 1154488393Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$15.3M

$15,288,106

Total Claims

208K

Beneficiaries

173K

1.2 claims/patient

Avg Cost/Claim

$74

Monthly Spending Trend

Yearly Spending

2018
$2.9M
-3%
2019
$2.8M
-40%
2020
$1.7M
+70%
2021
$2.9M
-11%
2022
$2.6M
-31%
2023
$1.8M
-61%
2024
$684K

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 56% of total spending.

99213Top 5%

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

$8.6M

60K claims · 56.4%

Your Cost: $142.98/claim|Median: $37.81
3.8× median
99212Top 5%

Office/outpatient visit, low complexity

$4.3M

30K claims · 28.1%

Your Cost: $141.82/claim|Median: $25.06
5.7× median
99308Top 5%

Nursing facility care, subsequent, straightforward

$978K

17K claims · 6.4%

Your Cost: $58.43/claim|Median: $9.79
6.0× median
99307Top 5%

$370K

8,630 claims · 2.4%

Your Cost: $42.91/claim|Median: $6.57
6.5× median
99214Top 25%

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

$323K

3,519 claims · 2.1%

Your Cost: $91.92/claim|Median: $53.41
1.7× median
99051Normal range

$149K

14K claims · 1.0%

Your Cost: $10.70/claim|Median: $7.89
1.4× median
99203Top 5%

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

$117K

822 claims · 0.8%

Your Cost: $142.28/claim|Median: $57.85
2.5× median
99392Top 5%

Preventive medicine, established patient, age 1-4

$115K

598 claims · 0.8%

Your Cost: $192.13/claim|Median: $75.18
2.6× median
99318Top 5%

$82K

1,093 claims · 0.5%

Your Cost: $75.13/claim|Median: $15.64
4.8× median
99202Top 5%

Office/outpatient visit, new patient, low complexity

$61K

400 claims · 0.4%

Your Cost: $151.67/claim|Median: $40.11
3.8× median
G0511Top 25%

RHC/FQHC visit, psychiatric collaborative care model

$36K

2,007 claims · 0.2%

Your Cost: $17.93/claim|Median: $11.35
1.6× median
99393Top 5%

Preventive medicine, established patient, age 5-11

$25K

134 claims · 0.2%

Your Cost: $189.08/claim|Median: $74.82
2.5× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$23K

2,341 claims · 0.2%

Your Cost: $9.99/claim|Median: $9.56
1.0× median
99394Top 5%

Preventive medicine, established patient, age 12-17

$22K

127 claims · 0.1%

Your Cost: $172.91/claim|Median: $80.15
2.2× median
90670Top 5%

$19K

277 claims · 0.1%

Your Cost: $68.08/claim|Median: $5.94
11.5× median
99309Top 5%

Nursing facility care, subsequent, low complexity

$11K

169 claims · 0.1%

Your Cost: $63.23/claim|Median: $14.00
4.5× median
99201Top 5%

Office/outpatient visit, new patient, straightforward

$9K

53 claims · 0.1%

Your Cost: $170.56/claim|Median: $27.38
6.2× median
1000FTop 25%

$6K

12K claims · 0.0%

Your Cost: $0.49/claim|Median: $0.01
49.0× median
90651Top 25%

HPV vaccine, 9-valent

$3K

96 claims · 0.0%

Your Cost: $33.54/claim|Median: $8.93
3.8× median
99305Normal range

$3K

84 claims · 0.0%

Your Cost: $30.64/claim|Median: $19.28
1.6× median
G2025Normal range

$2K

97 claims · 0.0%

Your Cost: $19.60/claim|Median: $15.63
1.3× median
90734Normal range

$1K

105 claims · 0.0%

Your Cost: $13.10/claim|Median: $6.40
2.0× median
90791Normal range

Psychiatric diagnostic evaluation

$832

36 claims · 0.0%

Your Cost: $23.11/claim|Median: $99.21
0.2× median
99441Normal range

Telephone E/M by physician, 5-10 min

$461

37 claims · 0.0%

Your Cost: $12.45/claim|Median: $13.30
0.9× median
99304Normal range

$262

14 claims · 0.0%

Your Cost: $18.73/claim|Median: $13.51
1.4× median
81001Normal range

Urinalysis, automated, with microscopy

$254

144 claims · 0.0%

Your Cost: $1.77/claim|Median: $2.03
0.9× median
J1050Normal range

Injection, medroxyprogesterone acetate, one milligram

$254

13 claims · 0.0%

Your Cost: $19.56/claim|Median: $41.92
0.5× median
G0444Normal range

Annual depression screening, fifteen minutes

$22

3,084 claims · 0.0%

Your Cost: $0.01/claim|Median: $4.23
0.0× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$18

399 claims · 0.0%

Your Cost: $0.05/claim|Median: $7.18
0.0× median
90472Normal range

Immunization administration, each additional vaccine

$10

1,221 claims · 0.0%

Your Cost: $0.01/claim|Median: $11.79
0.0× median
← All providersHow we detect fraud →