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

⚖️ Compare🖨️ Print Report

Provider 1215364633

NPI: 1215364633Share
Active Billing Period:2018-01→2022-03(51 months)
Billing appears to have stoppedLast active: 2022-03

Total Paid

$9.1M

$9,122,145

Total Claims

445K

Beneficiaries

279K

1.6 claims/patient

Avg Cost/Claim

$21

Monthly Spending Trend

Yearly Spending

2018
$4.8M
-55%
2019
$2.2M
-29%
2020
$1.5M
-67%
2021
$502K
-78%
2022
$110K

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 33% of total spending.

99213Normal range

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

$3.0M

70K claims · 32.5%

Your Cost: $42.40/claim|Median: $37.81
1.1× median
99393Normal range

Preventive medicine, established patient, age 5-11

$1.3M

20K claims · 14.1%

Your Cost: $65.25/claim|Median: $74.82
0.9× median
99394Normal range

Preventive medicine, established patient, age 12-17

$979K

14K claims · 10.7%

Your Cost: $71.01/claim|Median: $80.15
0.9× median
99392Normal range

Preventive medicine, established patient, age 1-4

$818K

13K claims · 9.0%

Your Cost: $64.57/claim|Median: $75.18
0.9× median
96160Top 25%

Patient-focused health risk assessment

$517K

64K claims · 5.7%

Your Cost: $8.07/claim|Median: $2.10
3.8× median
99214Normal range

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

$480K

7,692 claims · 5.3%

Your Cost: $62.34/claim|Median: $53.41
1.2× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$395K

6,859 claims · 4.3%

Your Cost: $57.58/claim|Median: $69.35
0.8× median
99212Normal range

Office/outpatient visit, low complexity

$271K

10K claims · 3.0%

Your Cost: $26.85/claim|Median: $25.06
1.1× median
92551Normal range

Screening audiometry, pure tone, air only

$261K

37K claims · 2.9%

Your Cost: $6.98/claim|Median: $6.61
1.1× median
96110Normal range

Developmental screening, per standardized instrument

$230K

30K claims · 2.5%

Your Cost: $7.59/claim|Median: $9.10
0.8× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$210K

10K claims · 2.3%

Your Cost: $20.75/claim|Median: $17.85
1.2× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$170K

54K claims · 1.9%

Your Cost: $3.15/claim|Median: $3.67
0.9× median
99173Normal range

$99K

42K claims · 1.1%

Your Cost: $2.39/claim|Median: $2.16
1.1× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$50K

6,742 claims · 0.6%

Your Cost: $7.49/claim|Median: $11.48
0.7× median
90837Normal range

Psychotherapy, 60 minutes

$43K

550 claims · 0.5%

Your Cost: $78.37/claim|Median: $85.66
0.9× median
92552Normal range

Pure tone audiometry, air only, each ear

$41K

2,119 claims · 0.5%

Your Cost: $19.58/claim|Median: $12.63
1.6× median
99395Normal range

Preventive medicine, established patient, age 18-39

$40K

661 claims · 0.4%

Your Cost: $60.02/claim|Median: $72.71
0.8× median
87804Normal range

Influenza virus detection, rapid test

$25K

2,891 claims · 0.3%

Your Cost: $8.51/claim|Median: $12.59
0.7× median
99384Normal range

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

$23K

259 claims · 0.2%

Your Cost: $87.76/claim|Median: $83.63
1.0× median
99215Normal range

Office/outpatient visit, high complexity

$18K

218 claims · 0.2%

Your Cost: $84.07/claim|Median: $74.09
1.1× median
99383Normal range

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

$14K

253 claims · 0.2%

Your Cost: $54.14/claim|Median: $81.92
0.7× median
99381Normal range

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

$12K

237 claims · 0.1%

Your Cost: $51.47/claim|Median: $73.46
0.7× median
80061Normal range

Lipid panel

$12K

2,567 claims · 0.1%

Your Cost: $4.66/claim|Median: $8.41
0.6× median
95165Normal range

Professional services for allergen immunotherapy, per injection

$12K

211 claims · 0.1%

Your Cost: $56.03/claim|Median: $144.04
0.4× median
90832Normal range

Psychotherapy, 30 minutes

$11K

293 claims · 0.1%

Your Cost: $36.79/claim|Median: $41.28
0.9× median
99239Top 25%

Hospital discharge day management, more than 30 minutes

$10K

130 claims · 0.1%

Your Cost: $77.95/claim|Median: $43.85
1.8× median
96161Top 25%

$10K

1,507 claims · 0.1%

Your Cost: $6.68/claim|Median: $2.49
2.7× median
81025Normal range

Urine pregnancy test

$10K

2,230 claims · 0.1%

Your Cost: $4.39/claim|Median: $4.81
0.9× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$8K

107 claims · 0.1%

Your Cost: $75.45/claim|Median: $62.48
1.2× median
90471Normal range

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

$8K

735 claims · 0.1%

Your Cost: $10.83/claim|Median: $9.80
1.1× median
← All providersHow we detect fraud →