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Provider 1205896719

NPI: 1205896719Share
Active Billing Period:2018-01→2024-12(82 months)

Total Paid

$12.8M

$12,800,462

Total Claims

68K

Beneficiaries

56K

1.2 claims/patient

Avg Cost/Claim

$187

Monthly Spending Trend

Yearly Spending

2018
$11K
-50%
2019
$5K
+32288%
2020
$1.8M
+6%
2021
$1.9M
+72%
2022
$3.2M
-6%
2023
$3.0M
-4%
2024
$2.9M

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 40% of total spending.

99213Top 1%

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

$5.2M

21K claims · 40.5%

Your Cost: $243.89/claim|Median: $37.81
6.5× median
99214Top 5%

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

$2.3M

14K claims · 18.0%

Your Cost: $166.72/claim|Median: $53.41
3.1× median
99212Top 1%

Office/outpatient visit, low complexity

$1.5M

6,015 claims · 12.0%

Your Cost: $256.15/claim|Median: $25.06
10.2× median
99392Top 1%

Preventive medicine, established patient, age 1-4

$771K

2,782 claims · 6.0%

Your Cost: $277.15/claim|Median: $75.18
3.7× median
99391Top 1%

Preventive medicine, established patient, infant (under 1)

$677K

2,459 claims · 5.3%

Your Cost: $275.49/claim|Median: $69.35
4.0× median
T1015Top 25%

Clinic visit/encounter, all-inclusive

$655K

3,204 claims · 5.1%

Your Cost: $204.57/claim|Median: $121.16
1.7× median
99393Top 1%

Preventive medicine, established patient, age 5-11

$646K

2,424 claims · 5.0%

Your Cost: $266.63/claim|Median: $74.82
3.6× median
99394Top 1%

Preventive medicine, established patient, age 12-17

$446K

1,657 claims · 3.5%

Your Cost: $268.98/claim|Median: $80.15
3.4× median
99395Top 1%

Preventive medicine, established patient, age 18-39

$231K

830 claims · 1.8%

Your Cost: $278.24/claim|Median: $72.71
3.8× median
99396Top 1%

Preventive medicine, established patient, age 40-64

$188K

657 claims · 1.5%

Your Cost: $286.04/claim|Median: $76.06
3.8× median
99211Top 1%

Office/outpatient visit, minimal complexity

$28K

135 claims · 0.2%

Your Cost: $210.22/claim|Median: $12.93
16.3× median
99381Top 1%

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

$21K

61 claims · 0.2%

Your Cost: $342.89/claim|Median: $73.46
4.7× median
90670Normal range

$11K

1,899 claims · 0.1%

Your Cost: $5.63/claim|Median: $5.94
0.9× median
90698Normal range

$10K

1,689 claims · 0.1%

Your Cost: $5.70/claim|Median: $6.32
0.9× median
99383Top 1%

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

$9K

32 claims · 0.1%

Your Cost: $274.35/claim|Median: $81.92
3.3× median
90688Normal range

$8K

1,257 claims · 0.1%

Your Cost: $6.53/claim|Median: $9.00
0.7× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$7K

1,602 claims · 0.1%

Your Cost: $4.59/claim|Median: $7.18
0.6× median
90677Normal range

$7K

329 claims · 0.1%

Your Cost: $20.34/claim|Median: $12.96
1.6× median
90681Normal range

$6K

839 claims · 0.0%

Your Cost: $7.42/claim|Median: $5.74
1.3× median
90734Normal range

$6K

588 claims · 0.0%

Your Cost: $9.76/claim|Median: $6.40
1.5× median
H0015Top 25%

Alcohol and/or drug abuse, intensive outpatient, per hour

$5K

29 claims · 0.0%

Your Cost: $185.13/claim|Median: $129.75
1.4× median
99385Top 1%

Preventive visit, new patient, 18-39 yr

$5K

20 claims · 0.0%

Your Cost: $261.09/claim|Median: $76.22
3.4× median
90633Normal range

$5K

852 claims · 0.0%

Your Cost: $6.05/claim|Median: $3.56
1.7× median
90649Normal range

$5K

706 claims · 0.0%

Your Cost: $6.93/claim|Median: $6.42
1.1× median
99386Top 5%

Preventive visit, new patient, 40-64 yr

$5K

16 claims · 0.0%

Your Cost: $293.04/claim|Median: $87.82
3.3× median
90710Normal range

MMRV vaccine

$4K

572 claims · 0.0%

Your Cost: $7.36/claim|Median: $7.00
1.1× median
90744Normal range

$3K

525 claims · 0.0%

Your Cost: $5.98/claim|Median: $5.00
1.2× median
90723Normal range

DTaP-HepB-IPV vaccine

$3K

394 claims · 0.0%

Your Cost: $7.14/claim|Median: $5.78
1.2× median
0513FNormal range

$2K

454 claims · 0.0%

Your Cost: $4.16/claim|Median: $2.71
1.5× median
G0467Normal range

Federally qualified health center visit, mental health

$1K

272 claims · 0.0%

Your Cost: $4.04/claim|Median: $21.91
0.2× median
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