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Provider 1205203023

NPI: 1205203023Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$13.8M

$13,798,484

Total Claims

191K

Beneficiaries

153K

1.2 claims/patient

Avg Cost/Claim

$72

Monthly Spending Trend

Yearly Spending

2018
$1.2M
+56%
2019
$1.9M
-20%
2020
$1.5M
+55%
2021
$2.4M
+13%
2022
$2.7M
-4%
2023
$2.6M
-39%
2024
$1.6M

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 59% of total spending.

99213Top 5%

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

$8.2M

75K claims · 59.3%

Your Cost: $109.49/claim|Median: $37.81
2.9× median
99214Top 10%

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

$2.0M

19K claims · 14.8%

Your Cost: $109.40/claim|Median: $53.41
2.0× median
99212Top 10%

Office/outpatient visit, low complexity

$1.0M

12K claims · 7.5%

Your Cost: $86.26/claim|Median: $25.06
3.4× median
99393Top 10%

Preventive medicine, established patient, age 5-11

$509K

4,778 claims · 3.7%

Your Cost: $106.50/claim|Median: $74.82
1.4× median
99203Top 5%

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

$359K

2,923 claims · 2.6%

Your Cost: $122.83/claim|Median: $57.85
2.1× median
99394Normal range

Preventive medicine, established patient, age 12-17

$256K

3,351 claims · 1.9%

Your Cost: $76.51/claim|Median: $80.15
1.0× median
11721Top 1%

$256K

1,558 claims · 1.9%

Your Cost: $164.45/claim|Median: $8.56
19.2× median
99392Top 5%

Preventive medicine, established patient, age 1-4

$195K

1,212 claims · 1.4%

Your Cost: $160.56/claim|Median: $75.18
2.1× median
99391Top 5%

Preventive medicine, established patient, infant (under 1)

$138K

886 claims · 1.0%

Your Cost: $156.29/claim|Median: $69.35
2.3× median
G0467Normal range

Federally qualified health center visit, mental health

$138K

8,787 claims · 1.0%

Your Cost: $15.65/claim|Median: $21.91
0.7× median
99204Top 25%

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

$137K

1,038 claims · 1.0%

Your Cost: $131.54/claim|Median: $84.03
1.6× median
96127Top 10%

Brief emotional/behavioral assessment, per standardized instrument

$82K

5,670 claims · 0.6%

Your Cost: $14.50/claim|Median: $3.67
4.0× median
99211Top 5%

Office/outpatient visit, minimal complexity

$58K

507 claims · 0.4%

Your Cost: $113.47/claim|Median: $12.93
8.8× median
99395Top 5%

Preventive medicine, established patient, age 18-39

$49K

286 claims · 0.4%

Your Cost: $170.87/claim|Median: $72.71
2.4× median
97140Top 10%

Manual therapy techniques, per 15 minutes

$45K

1,148 claims · 0.3%

Your Cost: $39.57/claim|Median: $16.79
2.4× median
36415Top 25%

Collection of venous blood by venipuncture

$34K

8,530 claims · 0.2%

Your Cost: $3.94/claim|Median: $1.57
2.5× median
0001ATop 10%

COVID-19 vaccine admin, Pfizer, 1st dose

$28K

499 claims · 0.2%

Your Cost: $56.29/claim|Median: $33.72
1.7× median
90471Normal range

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

$28K

5,494 claims · 0.2%

Your Cost: $5.03/claim|Median: $9.80
0.5× median
0012ATop 5%

COVID-19 vaccine admin, Moderna, 2nd dose

$26K

348 claims · 0.2%

Your Cost: $74.99/claim|Median: $33.85
2.2× median
0002ATop 5%

COVID-19 vaccine admin, Pfizer, 2nd dose

$21K

290 claims · 0.2%

Your Cost: $73.03/claim|Median: $36.70
2.0× median
0011ATop 10%

COVID-19 vaccine admin, Moderna, 1st dose

$19K

454 claims · 0.1%

Your Cost: $42.49/claim|Median: $25.93
1.6× median
T1013Normal range

Sign language or oral interpretive services, per 15 minutes

$18K

1,355 claims · 0.1%

Your Cost: $13.21/claim|Median: $17.67
0.7× median
90832Top 10%

Psychotherapy, 30 minutes

$17K

159 claims · 0.1%

Your Cost: $107.42/claim|Median: $41.28
2.6× median
99396Top 1%

Preventive medicine, established patient, age 40-64

$16K

88 claims · 0.1%

Your Cost: $179.09/claim|Median: $76.06
2.4× median
90834Top 10%

Psychotherapy, 45 minutes

$14K

103 claims · 0.1%

Your Cost: $136.91/claim|Median: $63.65
2.2× median
99385Top 25%

Preventive visit, new patient, 18-39 yr

$13K

107 claims · 0.1%

Your Cost: $117.67/claim|Median: $76.22
1.5× median
99202Top 10%

Office/outpatient visit, new patient, low complexity

$8K

70 claims · 0.1%

Your Cost: $109.21/claim|Median: $40.11
2.7× median
99384Normal range

Preventive visit, new patient, adolescent (12-17 yr)

$7K

73 claims · 0.0%

Your Cost: $92.30/claim|Median: $83.63
1.1× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$6K

611 claims · 0.0%

Your Cost: $9.81/claim|Median: $9.56
1.0× median
0013ANormal range

$5K

136 claims · 0.0%

Your Cost: $33.76/claim|Median: $35.38
1.0× median
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