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

⚖️ Compare🖨️ Print Report

Provider 1194276105

NPI: 1194276105Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$12.4M

$12,359,904

Total Claims

99K

Beneficiaries

88K

1.1 claims/patient

Avg Cost/Claim

$125

Monthly Spending Trend

Yearly Spending

2018
$1.4M
+73%
2019
$2.4M
-12%
2020
$2.1M
-11%
2021
$1.8M
+8%
2022
$2.0M
-23%
2023
$1.5M
-19%
2024
$1.2M

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 47% of total spending.

99213Top 1%

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

$5.8M

32K claims · 46.9%

Your Cost: $181.73/claim|Median: $37.81
4.8× median
99214Top 5%

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

$5.0M

27K claims · 40.8%

Your Cost: $184.73/claim|Median: $53.41
3.5× median
H0031Normal range

Mental health assessment by non-physician

$479K

3,854 claims · 3.9%

Your Cost: $124.24/claim|Median: $96.18
1.3× median
90832Top 5%

Psychotherapy, 30 minutes

$273K

1,499 claims · 2.2%

Your Cost: $182.18/claim|Median: $41.28
4.4× median
H0025Top 25%

Behavioral health prevention education, per session

$246K

2,344 claims · 2.0%

Your Cost: $105.12/claim|Median: $36.25
2.9× median
99212Top 5%

Office/outpatient visit, low complexity

$220K

1,357 claims · 1.8%

Your Cost: $161.79/claim|Median: $25.06
6.5× median
99391Top 5%

Preventive medicine, established patient, infant (under 1)

$114K

580 claims · 0.9%

Your Cost: $196.42/claim|Median: $69.35
2.8× median
G0467Normal range

Federally qualified health center visit, mental health

$82K

3,201 claims · 0.7%

Your Cost: $25.67/claim|Median: $21.91
1.2× median
H0023Top 25%

Behavioral health outreach service, per 15 minutes

$26K

167 claims · 0.2%

Your Cost: $158.28/claim|Median: $53.97
2.9× median
99203Top 5%

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

$20K

99 claims · 0.2%

Your Cost: $205.85/claim|Median: $57.85
3.6× median
90471Normal range

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

$17K

2,455 claims · 0.1%

Your Cost: $6.89/claim|Median: $9.80
0.7× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$15K

716 claims · 0.1%

Your Cost: $21.15/claim|Median: $17.85
1.2× median
90792Top 10%

Psychiatric diagnostic evaluation with medical services

$12K

39 claims · 0.1%

Your Cost: $301.91/claim|Median: $108.91
2.8× median
99392Top 5%

Preventive medicine, established patient, age 1-4

$8K

39 claims · 0.1%

Your Cost: $202.24/claim|Median: $75.18
2.7× median
90791Normal range

Psychiatric diagnostic evaluation

$6K

81 claims · 0.0%

Your Cost: $69.18/claim|Median: $99.21
0.7× median
99202Top 5%

Office/outpatient visit, new patient, low complexity

$4K

19 claims · 0.0%

Your Cost: $198.56/claim|Median: $40.11
5.0× median
H0032Normal range

Mental health service plan development

$2K

42 claims · 0.0%

Your Cost: $47.62/claim|Median: $80.64
0.6× median
90461Normal range

Immunization admin, additional vaccine, counseling

$409

282 claims · 0.0%

Your Cost: $1.45/claim|Median: $6.93
0.2× median
G8510Normal range

$237

7,267 claims · 0.0%

Your Cost: $0.03/claim|Median: $1.96
0.0× median
98925Normal range

$208

13 claims · 0.0%

Your Cost: $15.97/claim|Median: $13.42
1.2× median
G2025Normal range

$203

14 claims · 0.0%

Your Cost: $14.47/claim|Median: $15.63
0.9× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$199

15 claims · 0.0%

Your Cost: $13.27/claim|Median: $9.56
1.4× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$51

3,767 claims · 0.0%

Your Cost: $0.01/claim|Median: $3.67
0.0× median
G8433Normal range

$37

5,992 claims · 0.0%

Your Cost: $0.01/claim|Median: $0.03
0.2× median
G8511Normal range

$0

33 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.28
90715Normal range

Tdap vaccine

$0

41 claims · 0.0%

Your Cost: $0.00/claim|Median: $10.32
90670Normal range

$0

165 claims · 0.0%

Your Cost: $0.00/claim|Median: $5.94
90472Normal range

Immunization administration, each additional vaccine

$0

177 claims · 0.0%

Your Cost: $0.00/claim|Median: $11.79
G8754Normal range

$0

79 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.01
90688Normal range

$0

907 claims · 0.0%

Your Cost: $0.00/claim|Median: $9.00
← All providersHow we detect fraud →