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HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - SPECIALTY CARE PC

Surgery, Surgical Critical Care·RED BANK, NJ·NPI: 1215989249Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$50.1M

$50,094,860

Total Claims

913K

Beneficiaries

733K

1.2 claims/patient

Avg Cost/Claim

$55

Monthly Spending Trend

Yearly Spending

2018
$4.1M
-6%
2019
$3.8M
-18%
2020
$3.1M
+74%
2021
$5.5M
+35%
2022
$7.4M
+88%
2023
$13.9M
-12%
2024
$12.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 18% of total spending.

99214Normal range

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

$8.8M

121K claims · 17.5%

Your Cost: $72.58/claim|Median: $53.41
1.4× median
99284Normal range

Emergency dept visit, high complexity

$8.5M

111K claims · 16.9%

Your Cost: $76.48/claim|Median: $69.51
1.1× median
99213Top 25%

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

$4.7M

87K claims · 9.4%

Your Cost: $54.24/claim|Median: $37.81
1.4× median
99285Normal range

Emergency dept visit, high/urgent complexity

$3.7M

44K claims · 7.4%

Your Cost: $85.22/claim|Median: $85.65
1.0× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$2.3M

81K claims · 4.5%

Your Cost: $27.83/claim|Median: $23.99
1.2× median
99283Normal range

Emergency dept visit, moderate complexity

$2.0M

40K claims · 3.9%

Your Cost: $49.76/claim|Median: $42.48
1.2× median
99204Top 25%

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

$2.0M

16K claims · 3.9%

Your Cost: $120.83/claim|Median: $84.03
1.4× median
90792Top 25%

Psychiatric diagnostic evaluation with medical services

$1.5M

6,398 claims · 2.9%

Your Cost: $226.95/claim|Median: $108.91
2.1× median
99215Top 25%

Office/outpatient visit, high complexity

$1.3M

12K claims · 2.6%

Your Cost: $112.63/claim|Median: $74.09
1.5× median
99291Normal range

Critical care, first 30-74 minutes

$1.2M

12K claims · 2.4%

Your Cost: $97.66/claim|Median: $101.24
1.0× median
93306Normal range

Echocardiography, transthoracic, complete, with Doppler

$1.2M

14K claims · 2.3%

Your Cost: $81.12/claim|Median: $54.68
1.5× median
99203Top 25%

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

$931K

9,975 claims · 1.9%

Your Cost: $93.30/claim|Median: $57.85
1.6× median
99233Normal range

Subsequent hospital care, per day, high complexity

$885K

24K claims · 1.8%

Your Cost: $36.68/claim|Median: $35.30
1.0× median
99223Normal range

Initial hospital care, per day, high complexity

$598K

9,945 claims · 1.2%

Your Cost: $60.16/claim|Median: $67.32
0.9× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$556K

4,336 claims · 1.1%

Your Cost: $128.24/claim|Median: $111.09
1.2× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$554K

20K claims · 1.1%

Your Cost: $27.56/claim|Median: $58.55
0.5× median
76819Normal range

Fetal biophysical profile with non-stress test

$553K

18K claims · 1.1%

Your Cost: $30.65/claim|Median: $49.45
0.6× median
99222Normal range

Initial hospital care, per day, moderate complexity

$456K

8,342 claims · 0.9%

Your Cost: $54.65/claim|Median: $51.25
1.1× median
99282Normal range

Emergency dept visit, low complexity

$439K

14K claims · 0.9%

Your Cost: $30.65/claim|Median: $37.72
0.8× median
93010Normal range

Electrocardiogram, interpretation and report only

$352K

81K claims · 0.7%

Your Cost: $4.34/claim|Median: $5.60
0.8× median
99469Normal range

Subsequent intensive care, very low birth weight infant

$341K

1,392 claims · 0.7%

Your Cost: $245.29/claim|Median: $293.45
0.8× median
95004Normal range

Percutaneous allergy skin tests, each

$333K

2,702 claims · 0.7%

Your Cost: $123.32/claim|Median: $134.97
0.9× median
93303Normal range

Echocardiography, transthoracic, limited

$296K

1,933 claims · 0.6%

Your Cost: $153.08/claim|Median: $112.83
1.4× median
90791Top 5%

Psychiatric diagnostic evaluation

$276K

1,277 claims · 0.6%

Your Cost: $216.21/claim|Median: $99.21
2.2× median
99472Normal range

Subsequent pediatric critical care, per day, age 2-5

$263K

1,119 claims · 0.5%

Your Cost: $235.05/claim|Median: $307.98
0.8× median
95810Normal range

Polysomnography, sleep study, 6+ hours

$252K

2,192 claims · 0.5%

Your Cost: $115.07/claim|Median: $233.73
0.5× median
99212Normal range

Office/outpatient visit, low complexity

$242K

8,079 claims · 0.5%

Your Cost: $29.96/claim|Median: $25.06
1.2× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$239K

4,978 claims · 0.5%

Your Cost: $48.09/claim|Median: $37.22
1.3× median
99480Normal range

Subsequent intensive care, very low birth weight infant

$237K

3,321 claims · 0.5%

Your Cost: $71.31/claim|Median: $98.15
0.7× median
90834Normal range

Psychotherapy, 45 minutes

$221K

4,713 claims · 0.4%

Your Cost: $46.97/claim|Median: $63.65
0.7× median
99395Top 25%

Preventive medicine, established patient, age 18-39

$221K

2,412 claims · 0.4%

Your Cost: $91.44/claim|Median: $72.71
1.3× median
93000Normal range

Electrocardiogram, complete, with interpretation and report

$209K

15K claims · 0.4%

Your Cost: $13.61/claim|Median: $9.70
1.4× median
76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$206K

2,422 claims · 0.4%

Your Cost: $84.99/claim|Median: $106.79
0.8× median
99231Normal range

Subsequent hospital care, per day, low complexity

$195K

10K claims · 0.4%

Your Cost: $18.92/claim|Median: $16.77
1.1× median
99396Top 25%

Preventive medicine, established patient, age 40-64

$168K

1,613 claims · 0.3%

Your Cost: $103.92/claim|Median: $76.06
1.4× median
43239Normal range

Upper GI endoscopy with biopsy

$167K

1,064 claims · 0.3%

Your Cost: $156.67/claim|Median: $151.68
1.0× median
99202Top 25%

Office/outpatient visit, new patient, low complexity

$161K

2,546 claims · 0.3%

Your Cost: $63.38/claim|Median: $40.11
1.6× median
95782Normal range

$159K

1,243 claims · 0.3%

Your Cost: $128.04/claim|Median: $216.35
0.6× median
59426Normal range

Antepartum care only, high risk, additional visits

$155K

1,170 claims · 0.3%

Your Cost: $132.77/claim|Median: $122.30
1.1× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$148K

3,099 claims · 0.3%

Your Cost: $47.75/claim|Median: $43.85
1.1× median
90832Normal range

Psychotherapy, 30 minutes

$142K

3,613 claims · 0.3%

Your Cost: $39.28/claim|Median: $41.28
1.0× median
93325Normal range

$134K

6,188 claims · 0.3%

Your Cost: $21.67/claim|Median: $14.61
1.5× median
99479Normal range

Subsequent intensive care, 2,501-5,000 grams

$127K

1,576 claims · 0.3%

Your Cost: $80.38/claim|Median: $103.70
0.8× median
76830Top 10%

Ultrasound, transvaginal

$114K

1,015 claims · 0.2%

Your Cost: $112.72/claim|Median: $57.47
2.0× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$107K

2,274 claims · 0.2%

Your Cost: $47.03/claim|Median: $62.48
0.8× median
45380Normal range

Colonoscopy with biopsy

$99K

502 claims · 0.2%

Your Cost: $197.38/claim|Median: $200.68
1.0× median
59409Normal range

Vaginal delivery only

$86K

162 claims · 0.2%

Your Cost: $533.64/claim|Median: $619.91
0.9× median
93320Normal range

$86K

1,908 claims · 0.2%

Your Cost: $45.09/claim|Median: $28.68
1.6× median
99442Normal range

Telephone E/M by physician, 11-20 minutes

$84K

3,037 claims · 0.2%

Your Cost: $27.55/claim|Median: $22.44
1.2× median
93970Normal range

Duplex scan of extremity veins, complete, bilateral

$82K

3,162 claims · 0.2%

Your Cost: $25.92/claim|Median: $43.07
0.6× median

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