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

⚖️ Compare🖨️ Print Report

Provider 1194797787

NPI: 1194797787Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$8.0M

$8,040,431

Total Claims

176K

Beneficiaries

150K

1.2 claims/patient

Avg Cost/Claim

$46

Monthly Spending Trend

Yearly Spending

2018
$397K
+11%
2019
$441K
+45%
2020
$639K
+73%
2021
$1.1M
+53%
2022
$1.7M
+12%
2023
$1.9M
-3%
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 32% of total spending.

99213Top 25%

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

$2.6M

43K claims · 32.3%

Your Cost: $60.79/claim|Median: $37.81
1.6× median
99214Top 25%

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

$1.2M

13K claims · 15.5%

Your Cost: $95.02/claim|Median: $53.41
1.8× median
92551Top 5%

Screening audiometry, pure tone, air only

$708K

17K claims · 8.8%

Your Cost: $40.64/claim|Median: $6.61
6.1× median
99393Normal range

Preventive medicine, established patient, age 5-11

$596K

8,319 claims · 7.4%

Your Cost: $71.69/claim|Median: $74.82
1.0× median
99392Normal range

Preventive medicine, established patient, age 1-4

$538K

7,629 claims · 6.7%

Your Cost: $70.51/claim|Median: $75.18
0.9× median
99212Top 25%

Office/outpatient visit, low complexity

$431K

10K claims · 5.4%

Your Cost: $41.34/claim|Median: $25.06
1.6× median
99394Normal range

Preventive medicine, established patient, age 12-17

$426K

5,933 claims · 5.3%

Your Cost: $71.83/claim|Median: $80.15
0.9× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$400K

6,011 claims · 5.0%

Your Cost: $66.53/claim|Median: $69.35
1.0× median
83036Top 5%

Hemoglobin A1c (glycated hemoglobin)

$144K

6,665 claims · 1.8%

Your Cost: $21.55/claim|Median: $5.50
3.9× median
D7140Top 5%

Extraction, erupted tooth or exposed root

$103K

905 claims · 1.3%

Your Cost: $113.62/claim|Median: $57.39
2.0× median
81025Top 25%

Urine pregnancy test

$95K

14K claims · 1.2%

Your Cost: $6.86/claim|Median: $4.81
1.4× median
G0467Normal range

Federally qualified health center visit, mental health

$78K

3,327 claims · 1.0%

Your Cost: $23.33/claim|Median: $21.91
1.1× median
99173Top 5%

$75K

2,498 claims · 0.9%

Your Cost: $30.09/claim|Median: $2.16
13.9× median
D0330Top 5%

Panoramic radiographic image

$75K

888 claims · 0.9%

Your Cost: $84.50/claim|Median: $37.36
2.3× median
99395Normal range

Preventive medicine, established patient, age 18-39

$62K

1,419 claims · 0.8%

Your Cost: $43.68/claim|Median: $72.71
0.6× median
81002Top 5%

Urinalysis, non-automated without microscopy

$58K

14K claims · 0.7%

Your Cost: $4.22/claim|Median: $2.00
2.1× median
82962Top 10%

Blood glucose test by monitoring device

$55K

7,968 claims · 0.7%

Your Cost: $6.94/claim|Median: $1.40
5.0× median
99203Top 25%

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

$44K

481 claims · 0.6%

Your Cost: $92.08/claim|Median: $57.85
1.6× median
D0274Top 1%

Bitewings, four radiographic images

$39K

770 claims · 0.5%

Your Cost: $51.17/claim|Median: $22.54
2.3× median
77067Top 5%

Screening mammography, bilateral, including CAD

$25K

192 claims · 0.3%

Your Cost: $129.39/claim|Median: $39.33
3.3× median
76817Top 5%

Ultrasound, pregnant uterus, transvaginal

$25K

174 claims · 0.3%

Your Cost: $142.51/claim|Median: $47.65
3.0× median
D1110Top 25%

Prophylaxis, adult cleaning

$22K

303 claims · 0.3%

Your Cost: $72.63/claim|Median: $43.38
1.7× median
H1000Normal range

Prenatal care, at-risk assessment

$22K

835 claims · 0.3%

Your Cost: $25.89/claim|Median: $50.36
0.5× median
99396Normal range

Preventive medicine, established patient, age 40-64

$20K

340 claims · 0.3%

Your Cost: $59.90/claim|Median: $76.06
0.8× median
99385Normal range

Preventive visit, new patient, 18-39 yr

$20K

282 claims · 0.2%

Your Cost: $70.23/claim|Median: $76.22
0.9× median
99383Normal range

Preventive visit, new patient, late childhood (5-11 yr)

$19K

243 claims · 0.2%

Your Cost: $76.45/claim|Median: $81.92
0.9× median
D0140Top 5%

Limited oral evaluation, problem focused

$17K

304 claims · 0.2%

Your Cost: $55.26/claim|Median: $27.07
2.0× median
D0220Top 1%

Intraoral periapical radiographic image, first film

$14K

475 claims · 0.2%

Your Cost: $30.23/claim|Median: $10.51
2.9× median
D0120Top 25%

Periodic oral evaluation, established patient

$11K

276 claims · 0.1%

Your Cost: $39.57/claim|Median: $24.34
1.6× median
D0150Top 25%

Comprehensive oral evaluation, new or established patient

$11K

176 claims · 0.1%

Your Cost: $60.66/claim|Median: $32.07
1.9× median
← All providersHow we detect fraud →