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Provider 1235439613

NPI: 1235439613Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$16.5M

$16,542,112

Total Claims

1.1M

Beneficiaries

739K

1.5 claims/patient

Avg Cost/Claim

$15

Monthly Spending Trend

Yearly Spending

2018
$1.4M
+21%
2019
$1.6M
-8%
2020
$1.5M
+42%
2021
$2.1M
+48%
2022
$3.1M
+8%
2023
$3.4M
-0%
2024
$3.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99199 (Unlisted special service, procedure, or report)) accounts for 22% of total spending.

99199Normal range

Unlisted special service, procedure, or report

$3.7M

622K claims · 22.4%

Your Cost: $5.95/claim|Median: $5.39
1.1× median
99214Top 25%

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

$3.2M

41K claims · 19.0%

Your Cost: $76.08/claim|Median: $53.41
1.4× median
99213Top 25%

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

$2.1M

39K claims · 12.6%

Your Cost: $53.94/claim|Median: $37.81
1.4× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$1.4M

17K claims · 8.4%

Your Cost: $79.43/claim|Median: $69.35
1.1× median
99392Normal range

Preventive medicine, established patient, age 1-4

$1.4M

17K claims · 8.3%

Your Cost: $83.04/claim|Median: $75.18
1.1× median
90472Top 10%

Immunization administration, each additional vaccine

$889K

26K claims · 5.4%

Your Cost: $33.84/claim|Median: $11.79
2.9× median
99393Normal range

Preventive medicine, established patient, age 5-11

$815K

10K claims · 4.9%

Your Cost: $79.88/claim|Median: $74.82
1.1× median
90471Top 25%

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

$707K

40K claims · 4.3%

Your Cost: $17.62/claim|Median: $9.80
1.8× median
0241UNormal range

Proprietary lab analysis, genomic sequencing

$701K

8,894 claims · 4.2%

Your Cost: $78.81/claim|Median: $91.47
0.9× median
99394Normal range

Preventive medicine, established patient, age 12-17

$340K

4,000 claims · 2.1%

Your Cost: $85.10/claim|Median: $80.15
1.1× median
96110Normal range

Developmental screening, per standardized instrument

$244K

33K claims · 1.5%

Your Cost: $7.43/claim|Median: $9.10
0.8× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$141K

13K claims · 0.8%

Your Cost: $10.93/claim|Median: $11.48
1.0× median
90474Top 10%

$107K

5,798 claims · 0.6%

Your Cost: $18.51/claim|Median: $8.42
2.2× median
87804Normal range

Influenza virus detection, rapid test

$104K

8,588 claims · 0.6%

Your Cost: $12.13/claim|Median: $12.59
1.0× median
92552Normal range

Pure tone audiometry, air only, each ear

$104K

24K claims · 0.6%

Your Cost: $4.25/claim|Median: $12.63
0.3× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$83K

23K claims · 0.5%

Your Cost: $3.59/claim|Median: $3.67
1.0× median
99215Normal range

Office/outpatient visit, high complexity

$76K

725 claims · 0.5%

Your Cost: $104.31/claim|Median: $74.09
1.4× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$75K

2,388 claims · 0.5%

Your Cost: $31.61/claim|Median: $57.30
0.6× median
83655Normal range

$53K

4,540 claims · 0.3%

Your Cost: $11.57/claim|Median: $10.49
1.1× median
99381Normal range

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

$39K

498 claims · 0.2%

Your Cost: $77.70/claim|Median: $73.46
1.1× median
99383Normal range

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

$35K

427 claims · 0.2%

Your Cost: $82.96/claim|Median: $81.92
1.0× median
D1206Normal range

Topical application of fluoride varnish

$33K

2,390 claims · 0.2%

Your Cost: $13.91/claim|Median: $18.12
0.8× median
96161Normal range

$30K

9,581 claims · 0.2%

Your Cost: $3.13/claim|Median: $2.49
1.3× median
90651Normal range

HPV vaccine, 9-valent

$21K

2,203 claims · 0.1%

Your Cost: $9.41/claim|Median: $8.93
1.1× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$21K

377 claims · 0.1%

Your Cost: $54.38/claim|Median: $62.48
0.9× median
87811Normal range

SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-read

$17K

714 claims · 0.1%

Your Cost: $23.73/claim|Median: $30.53
0.8× median
G2211Normal range

$16K

6,790 claims · 0.1%

Your Cost: $2.37/claim|Median: $2.40
1.0× median
85018Normal range

$15K

11K claims · 0.1%

Your Cost: $1.43/claim|Median: $1.71
0.8× median
99382Normal range

Preventive visit, new patient, early childhood (1-4 yr)

$15K

190 claims · 0.1%

Your Cost: $79.64/claim|Median: $79.89
1.0× median
90734Normal range

$14K

1,425 claims · 0.1%

Your Cost: $9.79/claim|Median: $6.40
1.5× median
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