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Provider 1225053523

NPI: 1225053523Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$10.2M

$10,162,529

Total Claims

75K

Beneficiaries

71K

1.1 claims/patient

Avg Cost/Claim

$135

Monthly Spending Trend

Yearly Spending

2018
$2.1M
+3%
2019
$2.2M
+0%
2020
$2.2M
-1%
2021
$2.1M
-73%
2022
$580K
+1%
2023
$586K
-31%
2024
$403K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (43239 (Upper GI endoscopy with biopsy)) accounts for 17% of total spending.

43239Normal range

Upper GI endoscopy with biopsy

$1.7M

7,593 claims · 16.8%

Your Cost: $225.06/claim|Median: $151.68
1.5× median
46250Top 1%

$1.2M

3,526 claims · 11.4%

Your Cost: $329.27/claim|Median: $329.27
1.0× median
99213Normal range

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

$857K

16K claims · 8.4%

Your Cost: $52.04/claim|Median: $37.81
1.4× median
88312Top 1%

$705K

1,043 claims · 6.9%

Your Cost: $675.71/claim|Median: $24.56
27.5× median
88305Top 1%

Surgical pathology, gross and microscopic examination

$673K

1,541 claims · 6.6%

Your Cost: $436.81/claim|Median: $35.80
12.2× median
45385Normal range

Colonoscopy with polyp removal, snare technique

$613K

2,186 claims · 6.0%

Your Cost: $280.42/claim|Median: $255.17
1.1× median
45350Top 1%

$573K

1,348 claims · 5.6%

Your Cost: $425.09/claim|Median: $390.49
1.1× median
88313Top 1%

$514K

1,042 claims · 5.1%

Your Cost: $493.38/claim|Median: $18.95
26.0× median
46230Top 1%

$468K

3,930 claims · 4.6%

Your Cost: $119.10/claim|Median: $89.54
1.3× median
99203Top 25%

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

$342K

4,236 claims · 3.4%

Your Cost: $80.76/claim|Median: $57.85
1.4× median
99214Top 25%

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

$317K

3,943 claims · 3.1%

Your Cost: $80.48/claim|Median: $53.41
1.5× median
46930Normal range

$315K

3,681 claims · 3.1%

Your Cost: $85.71/claim|Median: $97.64
0.9× median
91120Top 10%

$293K

908 claims · 2.9%

Your Cost: $322.58/claim|Median: $184.78
1.7× median
45380Normal range

Colonoscopy with biopsy

$272K

1,390 claims · 2.7%

Your Cost: $195.82/claim|Median: $200.68
1.0× median
45378Normal range

Colonoscopy, diagnostic

$181K

759 claims · 1.8%

Your Cost: $238.66/claim|Median: $225.49
1.1× median
45398Normal range

$179K

461 claims · 1.8%

Your Cost: $388.08/claim|Median: $356.41
1.1× median
91065Normal range

$156K

2,894 claims · 1.5%

Your Cost: $54.02/claim|Median: $37.81
1.4× median
91122Top 25%

$150K

946 claims · 1.5%

Your Cost: $158.21/claim|Median: $97.26
1.6× median
46500Normal range

$132K

996 claims · 1.3%

Your Cost: $132.73/claim|Median: $107.68
1.2× median
45381Normal range

$94K

863 claims · 0.9%

Your Cost: $108.37/claim|Median: $160.60
0.7× median
46221Normal range

$85K

577 claims · 0.8%

Your Cost: $146.95/claim|Median: $120.31
1.2× median
99204Top 25%

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

$69K

499 claims · 0.7%

Your Cost: $138.01/claim|Median: $84.03
1.6× median
99212Normal range

Office/outpatient visit, low complexity

$42K

1,705 claims · 0.4%

Your Cost: $24.85/claim|Median: $25.06
1.0× median
95004Normal range

Percutaneous allergy skin tests, each

$40K

205 claims · 0.4%

Your Cost: $195.94/claim|Median: $134.97
1.5× median
86328Normal range

$38K

1,564 claims · 0.4%

Your Cost: $24.11/claim|Median: $20.52
1.2× median
51784Normal range

$26K

654 claims · 0.3%

Your Cost: $39.08/claim|Median: $30.27
1.3× median
43251Normal range

$19K

67 claims · 0.2%

Your Cost: $285.07/claim|Median: $170.26
1.7× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$17K

397 claims · 0.2%

Your Cost: $42.79/claim|Median: $39.70
1.1× median
45330Normal range

$17K

250 claims · 0.2%

Your Cost: $66.66/claim|Median: $122.71
0.5× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$11K

244 claims · 0.1%

Your Cost: $46.22/claim|Median: $40.11
1.2× median
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