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Provider 1235212036

NPI: 1235212036Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$16.5M

$16,542,054

Total Claims

391K

Beneficiaries

373K

1.0 claims/patient

Avg Cost/Claim

$42

Monthly Spending Trend

Yearly Spending

2018
$2.1M
+7%
2019
$2.2M
-28%
2020
$1.6M
+40%
2021
$2.3M
+22%
2022
$2.8M
+0%
2023
$2.8M
+2%
2024
$2.8M

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 41% of total spending.

99213Top 10%

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

$6.8M

90K claims · 40.8%

Your Cost: $74.73/claim|Median: $37.81
2.0× median
99214Top 10%

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

$2.1M

20K claims · 12.8%

Your Cost: $106.37/claim|Median: $53.41
2.0× median
90460Top 10%

Immunization administration, first vaccine/toxoid, with counseling

$1.8M

39K claims · 10.6%

Your Cost: $44.90/claim|Median: $17.85
2.5× median
99392Top 10%

Preventive medicine, established patient, age 1-4

$956K

7,698 claims · 5.8%

Your Cost: $124.13/claim|Median: $75.18
1.7× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$889K

20K claims · 5.4%

Your Cost: $45.19/claim|Median: $39.70
1.1× median
99393Top 10%

Preventive medicine, established patient, age 5-11

$718K

5,852 claims · 4.3%

Your Cost: $122.61/claim|Median: $74.82
1.6× median
99391Top 10%

Preventive medicine, established patient, infant (under 1)

$708K

6,389 claims · 4.3%

Your Cost: $110.83/claim|Median: $69.35
1.6× median
96127Top 5%

Brief emotional/behavioral assessment, per standardized instrument

$344K

17K claims · 2.1%

Your Cost: $20.30/claim|Median: $3.67
5.5× median
87651Normal range

Streptococcus Group A detection, nucleic acid, amplified probe

$324K

12K claims · 2.0%

Your Cost: $27.97/claim|Median: $28.46
1.0× median
99174Top 10%

$271K

15K claims · 1.6%

Your Cost: $18.46/claim|Median: $5.27
3.5× median
96160Top 5%

Patient-focused health risk assessment

$256K

13K claims · 1.5%

Your Cost: $19.89/claim|Median: $2.10
9.5× median
99051Normal range

$234K

31K claims · 1.4%

Your Cost: $7.48/claim|Median: $7.89
0.9× median
99394Top 10%

Preventive medicine, established patient, age 12-17

$220K

1,655 claims · 1.3%

Your Cost: $132.72/claim|Median: $80.15
1.7× median
96110Top 25%

Developmental screening, per standardized instrument

$203K

9,762 claims · 1.2%

Your Cost: $20.81/claim|Median: $9.10
2.3× median
99215Top 25%

Office/outpatient visit, high complexity

$186K

1,461 claims · 1.1%

Your Cost: $127.17/claim|Median: $74.09
1.7× median
90471Top 10%

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

$166K

8,462 claims · 1.0%

Your Cost: $19.60/claim|Median: $9.80
2.0× median
87804Normal range

Influenza virus detection, rapid test

$128K

13K claims · 0.8%

Your Cost: $9.97/claim|Median: $12.59
0.8× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$82K

7,951 claims · 0.5%

Your Cost: $10.34/claim|Median: $11.48
0.9× median
92551Normal range

Screening audiometry, pure tone, air only

$63K

10K claims · 0.4%

Your Cost: $6.01/claim|Median: $6.61
0.9× median
99245Normal range

Office consultation, high complexity

$42K

332 claims · 0.3%

Your Cost: $127.56/claim|Median: $143.30
0.9× median
36416Top 25%

$42K

13K claims · 0.3%

Your Cost: $3.20/claim|Median: $1.31
2.4× median
96161Top 5%

$17K

962 claims · 0.1%

Your Cost: $17.42/claim|Median: $2.49
7.0× median
99177Top 10%

$14K

730 claims · 0.1%

Your Cost: $18.97/claim|Median: $3.74
5.1× median
85025Top 25%

Complete blood count (CBC) with differential, automated

$13K

1,858 claims · 0.1%

Your Cost: $6.95/claim|Median: $4.71
1.5× median
99188Top 25%

$9K

378 claims · 0.1%

Your Cost: $23.32/claim|Median: $12.80
1.8× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$6K

282 claims · 0.0%

Your Cost: $22.61/claim|Median: $57.30
0.4× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$6K

17K claims · 0.0%

Your Cost: $0.37/claim|Median: $7.18
0.1× median
0072ANormal range

$6K

150 claims · 0.0%

Your Cost: $38.40/claim|Median: $39.57
1.0× median
0071ANormal range

$5K

149 claims · 0.0%

Your Cost: $36.81/claim|Median: $38.71
1.0× median
99203Top 5%

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

$4K

32 claims · 0.0%

Your Cost: $123.83/claim|Median: $57.85
2.1× median
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