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Provider 1174039531

NPI: 1174039531Share
Active Billing Period:2019-12→2024-11(60 months)

Total Paid

$9.4M

$9,382,906

Total Claims

187K

Beneficiaries

163K

1.1 claims/patient

Avg Cost/Claim

$50

Monthly Spending Trend

Yearly Spending

2019
$2K
+61086%
2020
$1.0M
+65%
2021
$1.7M
-2%
2022
$1.7M
+52%
2023
$2.6M
-8%
2024
$2.4M

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 15% of total spending.

99213Top 25%

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

$1.4M

21K claims · 15.0%

Your Cost: $66.98/claim|Median: $37.81
1.8× median
68761Top 25%

$1.0M

12K claims · 11.2%

Your Cost: $87.90/claim|Median: $60.32
1.5× median
68040Normal range

$990K

24K claims · 10.6%

Your Cost: $41.40/claim|Median: $30.05
1.4× median
76512Normal range

$898K

18K claims · 9.6%

Your Cost: $50.76/claim|Median: $43.41
1.2× median
99214Top 25%

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

$886K

9,334 claims · 9.4%

Your Cost: $94.93/claim|Median: $53.41
1.8× median
92014Top 25%

Ophthalmological exam, comprehensive, established patient

$702K

8,911 claims · 7.5%

Your Cost: $78.82/claim|Median: $47.08
1.7× median
92083Top 25%

Visual field exam, extended testing, bilateral

$664K

15K claims · 7.1%

Your Cost: $45.75/claim|Median: $29.82
1.5× median
92250Normal range

Fundus photography with interpretation and report

$427K

14K claims · 4.6%

Your Cost: $29.59/claim|Median: $27.95
1.1× median
92004Top 25%

Ophthalmological exam, comprehensive, new patient

$422K

4,028 claims · 4.5%

Your Cost: $104.72/claim|Median: $59.72
1.8× median
92012Top 25%

Ophthalmological exam, intermediate, established patient

$339K

5,642 claims · 3.6%

Your Cost: $60.06/claim|Median: $38.23
1.6× median
92100Top 25%

$305K

5,082 claims · 3.2%

Your Cost: $59.93/claim|Median: $30.29
2.0× median
92286Normal range

$266K

8,958 claims · 2.8%

Your Cost: $29.68/claim|Median: $29.05
1.0× median
92273Top 25%

$162K

1,952 claims · 1.7%

Your Cost: $82.77/claim|Median: $53.16
1.6× median
92020Top 25%

$146K

7,736 claims · 1.6%

Your Cost: $18.88/claim|Median: $12.46
1.5× median
92133Normal range

$115K

4,481 claims · 1.2%

Your Cost: $25.74/claim|Median: $19.09
1.3× median
92025Top 25%

$90K

3,863 claims · 1.0%

Your Cost: $23.34/claim|Median: $17.08
1.4× median
92285Normal range

$73K

4,513 claims · 0.8%

Your Cost: $16.23/claim|Median: $16.47
1.0× median
92202Normal range

$72K

6,270 claims · 0.8%

Your Cost: $11.46/claim|Median: $7.06
1.6× median
V2100Top 25%

Lens, sphere, single vision, plus or minus 4.00

$68K

1,953 claims · 0.7%

Your Cost: $34.63/claim|Median: $20.68
1.7× median
65778Top 25%

$52K

60 claims · 0.6%

Your Cost: $869.90/claim|Median: $282.76
3.1× median
V2020Top 25%

Frames, purchases

$46K

1,378 claims · 0.5%

Your Cost: $33.16/claim|Median: $19.33
1.7× median
95004Normal range

Percutaneous allergy skin tests, each

$42K

221 claims · 0.4%

Your Cost: $189.96/claim|Median: $134.97
1.4× median
92015Normal range

Determination of refractive state

$39K

2,846 claims · 0.4%

Your Cost: $13.72/claim|Median: $10.36
1.3× median
92060Normal range

$23K

519 claims · 0.2%

Your Cost: $44.36/claim|Median: $35.83
1.2× median
68801Normal range

$22K

484 claims · 0.2%

Your Cost: $45.22/claim|Median: $49.95
0.9× median
76514Normal range

$19K

2,288 claims · 0.2%

Your Cost: $8.15/claim|Median: $6.67
1.2× median
99212Top 25%

Office/outpatient visit, low complexity

$17K

418 claims · 0.2%

Your Cost: $41.21/claim|Median: $25.06
1.6× median
92134Top 25%

$16K

600 claims · 0.2%

Your Cost: $26.57/claim|Median: $15.46
1.7× median
92340Top 25%

Fitting of spectacles, except for aphakia

$13K

441 claims · 0.1%

Your Cost: $28.48/claim|Median: $19.46
1.5× median
67820Normal range

$9K

561 claims · 0.1%

Your Cost: $16.37/claim|Median: $11.69
1.4× median
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