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Provider 1235588831

NPI: 1235588831Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$7.5M

$7,509,603

Total Claims

338K

Beneficiaries

292K

1.2 claims/patient

Avg Cost/Claim

$22

Monthly Spending Trend

Yearly Spending

2018
$1.0M
+1%
2019
$1.1M
-26%
2020
$781K
+35%
2021
$1.1M
+19%
2022
$1.2M
-10%
2023
$1.1M
+7%
2024
$1.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 24% of total spending.

99214Normal range

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

$1.8M

50K claims · 23.7%

Your Cost: $35.31/claim|Median: $53.41
0.7× median
99213Normal range

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

$1.0M

42K claims · 13.9%

Your Cost: $25.04/claim|Median: $37.81
0.7× median
99284Normal range

Emergency dept visit, high complexity

$624K

17K claims · 8.3%

Your Cost: $37.07/claim|Median: $69.51
0.5× median
88305Normal range

Surgical pathology, gross and microscopic examination

$336K

12K claims · 4.5%

Your Cost: $27.07/claim|Median: $35.80
0.8× median
99285Normal range

Emergency dept visit, high/urgent complexity

$297K

8,097 claims · 4.0%

Your Cost: $36.70/claim|Median: $85.65
0.4× median
99215Normal range

Office/outpatient visit, high complexity

$287K

6,306 claims · 3.8%

Your Cost: $45.53/claim|Median: $74.09
0.6× median
90834Normal range

Psychotherapy, 45 minutes

$219K

4,585 claims · 2.9%

Your Cost: $47.77/claim|Median: $63.65
0.8× median
92014Normal range

Ophthalmological exam, comprehensive, established patient

$184K

8,340 claims · 2.4%

Your Cost: $22.01/claim|Median: $47.08
0.5× median
93010Normal range

Electrocardiogram, interpretation and report only

$158K

33K claims · 2.1%

Your Cost: $4.72/claim|Median: $5.60
0.8× median
99211Normal range

Office/outpatient visit, minimal complexity

$155K

14K claims · 2.1%

Your Cost: $10.84/claim|Median: $12.93
0.8× median
99233Normal range

Subsequent hospital care, per day, high complexity

$134K

7,981 claims · 1.8%

Your Cost: $16.83/claim|Median: $35.30
0.5× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$134K

2,497 claims · 1.8%

Your Cost: $53.67/claim|Median: $69.35
0.8× median
99392Normal range

Preventive medicine, established patient, age 1-4

$127K

2,224 claims · 1.7%

Your Cost: $57.10/claim|Median: $75.18
0.8× median
99223Normal range

Initial hospital care, per day, high complexity

$125K

2,676 claims · 1.7%

Your Cost: $46.87/claim|Median: $67.32
0.7× median
87651Normal range

Streptococcus Group A detection, nucleic acid, amplified probe

$123K

4,347 claims · 1.6%

Your Cost: $28.24/claim|Median: $28.46
1.0× median
99283Normal range

Emergency dept visit, moderate complexity

$99K

3,901 claims · 1.3%

Your Cost: $25.45/claim|Median: $42.48
0.6× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$89K

1,844 claims · 1.2%

Your Cost: $48.14/claim|Median: $43.85
1.1× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$87K

8,575 claims · 1.2%

Your Cost: $10.15/claim|Median: $23.99
0.4× median
U0003Normal range

Infectious disease detection (COVID-19)

$83K

1,294 claims · 1.1%

Your Cost: $64.11/claim|Median: $63.08
1.0× median
87631Normal range

Respiratory virus detection, 3-5 targets, multiplex

$79K

741 claims · 1.1%

Your Cost: $106.41/claim|Median: $65.45
1.6× median
92340Normal range

Fitting of spectacles, except for aphakia

$74K

3,699 claims · 1.0%

Your Cost: $20.03/claim|Median: $19.46
1.0× median
99203Normal range

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

$68K

1,212 claims · 0.9%

Your Cost: $56.04/claim|Median: $57.85
1.0× median
92015Normal range

Determination of refractive state

$59K

8,826 claims · 0.8%

Your Cost: $6.67/claim|Median: $10.36
0.6× median
67028Normal range

Intravitreal injection of a pharmacologic agent

$58K

1,286 claims · 0.8%

Your Cost: $44.84/claim|Median: $58.82
0.8× median
92004Normal range

Ophthalmological exam, comprehensive, new patient

$53K

1,572 claims · 0.7%

Your Cost: $33.65/claim|Median: $59.72
0.6× median
74177Normal range

CT abdomen and pelvis with contrast

$51K

1,401 claims · 0.7%

Your Cost: $36.64/claim|Median: $65.76
0.6× median
92134Normal range

$50K

4,855 claims · 0.7%

Your Cost: $10.28/claim|Median: $15.46
0.7× median
71046Normal range

Chest X-ray, 2 views

$49K

6,690 claims · 0.6%

Your Cost: $7.29/claim|Median: $8.92
0.8× median
71045Normal range

Chest X-ray, single view

$45K

13K claims · 0.6%

Your Cost: $3.35/claim|Median: $4.93
0.7× median
99393Normal range

Preventive medicine, established patient, age 5-11

$39K

637 claims · 0.5%

Your Cost: $60.71/claim|Median: $74.82
0.8× median
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