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Provider 1225145105

NPI: 1225145105Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$13.3M

$13,255,280

Total Claims

904K

Beneficiaries

832K

1.1 claims/patient

Avg Cost/Claim

$15

Monthly Spending Trend

Yearly Spending

2018
$1.6M
+37%
2019
$2.1M
-11%
2020
$1.9M
+26%
2021
$2.4M
-9%
2022
$2.2M
-7%
2023
$2.0M
-46%
2024
$1.1M

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 24% of total spending.

99213Normal range

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

$3.2M

92K claims · 24.4%

Your Cost: $35.25/claim|Median: $37.81
0.9× median
99214Normal range

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

$2.9M

59K claims · 21.7%

Your Cost: $49.06/claim|Median: $53.41
0.9× median
T1015Normal range

Clinic visit/encounter, all-inclusive

$1.5M

11K claims · 11.6%

Your Cost: $139.76/claim|Median: $121.16
1.2× median
99392Normal range

Preventive medicine, established patient, age 1-4

$636K

11K claims · 4.8%

Your Cost: $59.50/claim|Median: $75.18
0.8× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$534K

9,392 claims · 4.0%

Your Cost: $56.87/claim|Median: $69.35
0.8× median
90837Normal range

Psychotherapy, 60 minutes

$488K

10K claims · 3.7%

Your Cost: $48.46/claim|Median: $85.66
0.6× median
99393Normal range

Preventive medicine, established patient, age 5-11

$450K

8,535 claims · 3.4%

Your Cost: $52.68/claim|Median: $74.82
0.7× median
99394Normal range

Preventive medicine, established patient, age 12-17

$266K

4,960 claims · 2.0%

Your Cost: $53.57/claim|Median: $80.15
0.7× median
G0467Normal range

Federally qualified health center visit, mental health

$230K

17K claims · 1.7%

Your Cost: $13.57/claim|Median: $21.91
0.6× median
92004Normal range

Ophthalmological exam, comprehensive, new patient

$204K

2,930 claims · 1.5%

Your Cost: $69.61/claim|Median: $59.72
1.2× median
90834Normal range

Psychotherapy, 45 minutes

$202K

5,737 claims · 1.5%

Your Cost: $35.24/claim|Median: $63.65
0.6× median
92014Normal range

Ophthalmological exam, comprehensive, established patient

$190K

3,259 claims · 1.4%

Your Cost: $58.29/claim|Median: $47.08
1.2× median
H0004Normal range

Behavioral health counseling & therapy, per 15 min

$182K

4,033 claims · 1.4%

Your Cost: $45.12/claim|Median: $74.63
0.6× median
99204Normal range

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

$121K

1,474 claims · 0.9%

Your Cost: $81.91/claim|Median: $84.03
1.0× median
99203Normal range

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

$104K

1,848 claims · 0.8%

Your Cost: $56.52/claim|Median: $57.85
1.0× median
90832Normal range

Psychotherapy, 30 minutes

$95K

3,323 claims · 0.7%

Your Cost: $28.45/claim|Median: $41.28
0.7× median
99381Normal range

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

$89K

1,825 claims · 0.7%

Your Cost: $48.58/claim|Median: $73.46
0.7× median
90471Normal range

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

$84K

9,137 claims · 0.6%

Your Cost: $9.25/claim|Median: $9.80
0.9× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$75K

7,521 claims · 0.6%

Your Cost: $10.02/claim|Median: $7.18
1.4× median
92340Normal range

Fitting of spectacles, except for aphakia

$69K

4,048 claims · 0.5%

Your Cost: $17.00/claim|Median: $19.46
0.9× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$67K

31K claims · 0.5%

Your Cost: $2.16/claim|Median: $3.67
0.6× median
99212Normal range

Office/outpatient visit, low complexity

$64K

3,260 claims · 0.5%

Your Cost: $19.65/claim|Median: $25.06
0.8× median
90674Normal range

$63K

2,937 claims · 0.5%

Your Cost: $21.61/claim|Median: $15.16
1.4× median
90670Normal range

$62K

7,080 claims · 0.5%

Your Cost: $8.73/claim|Median: $5.94
1.5× median
92551Normal range

Screening audiometry, pure tone, air only

$60K

15K claims · 0.5%

Your Cost: $4.09/claim|Median: $6.61
0.6× median
87428Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay, each

$60K

1,544 claims · 0.5%

Your Cost: $38.69/claim|Median: $39.63
1.0× median
83037Normal range

$49K

7,936 claims · 0.4%

Your Cost: $6.23/claim|Median: $4.07
1.5× median
99205Top 25%

Office/outpatient visit, new patient, high complexity

$49K

309 claims · 0.4%

Your Cost: $157.48/claim|Median: $111.09
1.4× median
90688Normal range

$48K

5,909 claims · 0.4%

Your Cost: $8.11/claim|Median: $9.00
0.9× median
92015Normal range

Determination of refractive state

$48K

5,363 claims · 0.4%

Your Cost: $8.90/claim|Median: $10.36
0.9× median
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