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Provider 1154571222

NPI: 1154571222Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$13.4M

$13,355,061

Total Claims

286K

Beneficiaries

249K

1.1 claims/patient

Avg Cost/Claim

$47

Monthly Spending Trend

Yearly Spending

2018
$1.4M
-2%
2019
$1.4M
-3%
2020
$1.3M
+47%
2021
$2.0M
+55%
2022
$3.0M
-18%
2023
$2.5M
-27%
2024
$1.8M

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 38% of total spending.

99213Top 25%

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

$5.1M

75K claims · 38.2%

Your Cost: $68.14/claim|Median: $37.81
1.8× median
99214Top 25%

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

$3.7M

37K claims · 27.6%

Your Cost: $98.48/claim|Median: $53.41
1.8× median
99393Top 25%

Preventive medicine, established patient, age 5-11

$508K

5,698 claims · 3.8%

Your Cost: $89.18/claim|Median: $74.82
1.2× median
99212Top 25%

Office/outpatient visit, low complexity

$468K

11K claims · 3.5%

Your Cost: $44.22/claim|Median: $25.06
1.8× median
99394Top 25%

Preventive medicine, established patient, age 12-17

$441K

4,490 claims · 3.3%

Your Cost: $98.13/claim|Median: $80.15
1.2× median
99392Top 25%

Preventive medicine, established patient, age 1-4

$388K

4,316 claims · 2.9%

Your Cost: $89.99/claim|Median: $75.18
1.2× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$376K

17K claims · 2.8%

Your Cost: $22.57/claim|Median: $17.85
1.3× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$363K

7,920 claims · 2.7%

Your Cost: $45.89/claim|Median: $39.70
1.2× median
87804Top 25%

Influenza virus detection, rapid test

$363K

20K claims · 2.7%

Your Cost: $17.78/claim|Median: $12.59
1.4× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$314K

3,727 claims · 2.3%

Your Cost: $84.14/claim|Median: $69.35
1.2× median
87426Normal range

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

$191K

7,627 claims · 1.4%

Your Cost: $25.02/claim|Median: $30.04
0.8× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$128K

11K claims · 1.0%

Your Cost: $12.17/claim|Median: $11.48
1.1× median
95004Top 25%

Percutaneous allergy skin tests, each

$102K

378 claims · 0.8%

Your Cost: $268.86/claim|Median: $134.97
2.0× median
96110Normal range

Developmental screening, per standardized instrument

$90K

9,783 claims · 0.7%

Your Cost: $9.21/claim|Median: $9.10
1.0× median
90461Normal range

Immunization admin, additional vaccine, counseling

$65K

5,423 claims · 0.5%

Your Cost: $12.05/claim|Median: $6.93
1.7× median
36415Top 10%

Collection of venous blood by venipuncture

$55K

9,938 claims · 0.4%

Your Cost: $5.54/claim|Median: $1.57
3.5× median
99395Top 25%

Preventive medicine, established patient, age 18-39

$52K

537 claims · 0.4%

Your Cost: $96.18/claim|Median: $72.71
1.3× median
94664Top 25%

$48K

3,326 claims · 0.4%

Your Cost: $14.53/claim|Median: $8.88
1.6× median
97802Normal range

Medical nutrition therapy, reassessment, individual, fifteen minutes

$48K

16K claims · 0.4%

Your Cost: $3.06/claim|Median: $12.70
0.2× median
90677Top 10%

$44K

327 claims · 0.3%

Your Cost: $135.39/claim|Median: $12.96
10.4× median
99442Normal range

Telephone E/M by physician, 11-20 minutes

$41K

1,359 claims · 0.3%

Your Cost: $30.43/claim|Median: $22.44
1.4× median
95930Normal range

Visual evoked potential testing

$41K

920 claims · 0.3%

Your Cost: $44.81/claim|Median: $35.54
1.3× median
99204Top 25%

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

$39K

349 claims · 0.3%

Your Cost: $112.50/claim|Median: $84.03
1.3× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$38K

715 claims · 0.3%

Your Cost: $52.98/claim|Median: $62.48
0.8× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$35K

704 claims · 0.3%

Your Cost: $49.69/claim|Median: $37.22
1.3× median
99188Normal range

$32K

1,870 claims · 0.2%

Your Cost: $17.29/claim|Median: $12.80
1.4× median
99203Normal range

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

$31K

468 claims · 0.2%

Your Cost: $67.10/claim|Median: $57.85
1.2× median
92558Normal range

$27K

2,959 claims · 0.2%

Your Cost: $9.11/claim|Median: $6.67
1.4× median
99401Top 25%

$25K

831 claims · 0.2%

Your Cost: $29.85/claim|Median: $16.53
1.8× median
99462Normal range

$22K

728 claims · 0.2%

Your Cost: $30.06/claim|Median: $27.49
1.1× median
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