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

⚖️ Compare🖨️ Print Report

Provider 1164471116

NPI: 1164471116Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$14.5M

$14,450,155

Total Claims

1.0M

Beneficiaries

906K

1.1 claims/patient

Avg Cost/Claim

$14

Monthly Spending Trend

Yearly Spending

2018
$86K
-18%
2019
$71K
+406%
2020
$357K
+845%
2021
$3.4M
+17%
2022
$4.0M
-7%
2023
$3.7M
-21%
2024
$2.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99393 (Preventive medicine, established patient, age 5-11)) accounts for 17% of total spending.

99393Top 25%

Preventive medicine, established patient, age 5-11

$2.4M

26K claims · 16.6%

Your Cost: $93.89/claim|Median: $74.82
1.3× median
99392Normal range

Preventive medicine, established patient, age 1-4

$2.2M

25K claims · 15.1%

Your Cost: $88.58/claim|Median: $75.18
1.2× median
99394Top 25%

Preventive medicine, established patient, age 12-17

$2.0M

20K claims · 13.6%

Your Cost: $99.88/claim|Median: $80.15
1.2× median
99391Top 25%

Preventive medicine, established patient, infant (under 1)

$1.6M

18K claims · 10.9%

Your Cost: $86.02/claim|Median: $69.35
1.2× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$1.3M

98K claims · 8.7%

Your Cost: $12.85/claim|Median: $17.85
0.7× median
99213Normal range

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

$971K

140K claims · 6.7%

Your Cost: $6.91/claim|Median: $37.81
0.2× median
99429Top 25%

$792K

22K claims · 5.5%

Your Cost: $36.43/claim|Median: $28.58
1.3× median
87811Normal range

SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-read

$566K

16K claims · 3.9%

Your Cost: $34.75/claim|Median: $30.53
1.1× median
99050Top 1%

$481K

4,847 claims · 3.3%

Your Cost: $99.28/claim|Median: $11.81
8.4× median
87635Top 10%

COVID-19 SARS-CoV-2 amplified probe detection

$375K

7,124 claims · 2.6%

Your Cost: $52.58/claim|Median: $39.70
1.3× median
99214Normal range

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

$264K

25K claims · 1.8%

Your Cost: $10.70/claim|Median: $53.41
0.2× median
96110Normal range

Developmental screening, per standardized instrument

$248K

27K claims · 1.7%

Your Cost: $9.15/claim|Median: $9.10
1.0× median
90471Normal range

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

$146K

16K claims · 1.0%

Your Cost: $9.34/claim|Median: $9.80
1.0× median
90834Normal range

Psychotherapy, 45 minutes

$131K

1,747 claims · 0.9%

Your Cost: $74.79/claim|Median: $63.65
1.2× median
90472Normal range

Immunization administration, each additional vaccine

$123K

14K claims · 0.8%

Your Cost: $8.50/claim|Median: $11.79
0.7× median
99212Normal range

Office/outpatient visit, low complexity

$116K

21K claims · 0.8%

Your Cost: $5.40/claim|Median: $25.06
0.2× median
99381Normal range

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

$111K

1,254 claims · 0.8%

Your Cost: $88.82/claim|Median: $73.46
1.2× median
99051Normal range

$110K

27K claims · 0.8%

Your Cost: $4.03/claim|Median: $7.89
0.5× median
90791Normal range

Psychiatric diagnostic evaluation

$81K

713 claims · 0.6%

Your Cost: $114.04/claim|Median: $99.21
1.1× median
99395Top 25%

Preventive medicine, established patient, age 18-39

$77K

798 claims · 0.5%

Your Cost: $96.62/claim|Median: $72.71
1.3× median
87804Normal range

Influenza virus detection, rapid test

$74K

38K claims · 0.5%

Your Cost: $1.97/claim|Median: $12.59
0.2× median
90461Normal range

Immunization admin, additional vaccine, counseling

$72K

27K claims · 0.5%

Your Cost: $2.70/claim|Median: $6.93
0.4× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$48K

24K claims · 0.3%

Your Cost: $1.97/claim|Median: $11.48
0.2× median
96160Normal range

Patient-focused health risk assessment

$46K

24K claims · 0.3%

Your Cost: $1.95/claim|Median: $2.10
0.9× median
G8510Top 25%

$35K

2,856 claims · 0.2%

Your Cost: $12.12/claim|Median: $1.96
6.2× median
83655Normal range

$21K

2,066 claims · 0.1%

Your Cost: $10.36/claim|Median: $10.49
1.0× median
87070Normal range

Bacterial culture, any source except blood or urine

$20K

19K claims · 0.1%

Your Cost: $1.02/claim|Median: $5.89
0.2× median
90620Normal range

$15K

2,304 claims · 0.1%

Your Cost: $6.43/claim|Median: $6.49
1.0× median
0071ANormal range

$13K

322 claims · 0.1%

Your Cost: $41.52/claim|Median: $38.71
1.1× median
90474Normal range

$13K

1,505 claims · 0.1%

Your Cost: $8.60/claim|Median: $8.42
1.0× median
← All providersHow we detect fraud →