Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

⚖️ Compare🖨️ Print Report

Provider 1245253160

NPI: 1245253160Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$8.2M

$8,234,816

Total Claims

732K

Beneficiaries

635K

1.2 claims/patient

Avg Cost/Claim

$11

Monthly Spending Trend

Yearly Spending

2018
$1.5M
-34%
2019
$985K
+37%
2020
$1.3M
-1%
2021
$1.3M
-8%
2022
$1.2M
-11%
2023
$1.1M
-28%
2024
$787K

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 27% of total spending.

99213Normal range

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

$2.2M

68K claims · 27.1%

Your Cost: $32.85/claim|Median: $37.81
0.9× median
99214Normal range

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

$1.3M

27K claims · 16.4%

Your Cost: $49.13/claim|Median: $53.41
0.9× median
99212Normal range

Office/outpatient visit, low complexity

$316K

15K claims · 3.8%

Your Cost: $21.44/claim|Median: $25.06
0.9× median
87591Normal range

Neisseria gonorrhoeae detection, nucleic acid, amplified probe

$261K

9,566 claims · 3.2%

Your Cost: $27.26/claim|Median: $23.39
1.2× median
90832Normal range

Psychotherapy, 30 minutes

$198K

5,655 claims · 2.4%

Your Cost: $34.94/claim|Median: $41.28
0.8× median
80050Normal range

General health panel

$188K

5,391 claims · 2.3%

Your Cost: $34.95/claim|Median: $25.59
1.4× median
87491Normal range

Chlamydia detection, nucleic acid, amplified probe

$177K

6,207 claims · 2.1%

Your Cost: $28.49/claim|Median: $24.95
1.1× median
80061Normal range

Lipid panel

$176K

18K claims · 2.1%

Your Cost: $9.79/claim|Median: $8.41
1.2× median
90791Normal range

Psychiatric diagnostic evaluation

$166K

2,450 claims · 2.0%

Your Cost: $67.61/claim|Median: $99.21
0.7× median
99392Normal range

Preventive medicine, established patient, age 1-4

$158K

3,010 claims · 1.9%

Your Cost: $52.42/claim|Median: $75.18
0.7× median
D0330Normal range

Panoramic radiographic image

$146K

4,201 claims · 1.8%

Your Cost: $34.82/claim|Median: $37.36
0.9× median
99408Normal range

$134K

9,016 claims · 1.6%

Your Cost: $14.91/claim|Median: $9.32
1.6× median
D0140Normal range

Limited oral evaluation, problem focused

$127K

4,179 claims · 1.5%

Your Cost: $30.35/claim|Median: $27.07
1.1× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$125K

4,461 claims · 1.5%

Your Cost: $28.13/claim|Median: $32.07
0.9× median
87636Normal range

Respiratory virus detection, 6-11 targets, nucleic acid

$95K

889 claims · 1.2%

Your Cost: $107.34/claim|Median: $97.61
1.1× median
99442Normal range

Telephone E/M by physician, 11-20 minutes

$94K

2,466 claims · 1.1%

Your Cost: $38.20/claim|Median: $22.44
1.7× median
84443Normal range

Thyroid stimulating hormone (TSH)

$93K

10K claims · 1.1%

Your Cost: $8.93/claim|Median: $9.87
0.9× median
99173Top 5%

$89K

3,701 claims · 1.1%

Your Cost: $23.94/claim|Median: $2.16
11.1× median
87661Normal range

Trichomonas vaginalis detection, nucleic acid, amplified probe

$88K

3,566 claims · 1.1%

Your Cost: $24.71/claim|Median: $21.08
1.2× median
85025Normal range

Complete blood count (CBC) with differential, automated

$88K

14K claims · 1.1%

Your Cost: $6.14/claim|Median: $4.71
1.3× median
80053Normal range

Comprehensive metabolic panel

$85K

12K claims · 1.0%

Your Cost: $7.18/claim|Median: $7.24
1.0× median
87798Normal range

Infectious agent detection, nucleic acid, not otherwise specified

$83K

2,576 claims · 1.0%

Your Cost: $32.26/claim|Median: $26.72
1.2× median
99395Normal range

Preventive medicine, established patient, age 18-39

$83K

1,481 claims · 1.0%

Your Cost: $56.00/claim|Median: $72.71
0.8× median
99393Normal range

Preventive medicine, established patient, age 5-11

$82K

1,429 claims · 1.0%

Your Cost: $57.19/claim|Median: $74.82
0.8× median
G0467Normal range

Federally qualified health center visit, mental health

$81K

11K claims · 1.0%

Your Cost: $7.41/claim|Median: $21.91
0.3× median
D0220Normal range

Intraoral periapical radiographic image, first film

$65K

8,806 claims · 0.8%

Your Cost: $7.36/claim|Median: $10.51
0.7× median
83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$62K

9,416 claims · 0.8%

Your Cost: $6.59/claim|Median: $5.50
1.2× median
99394Normal range

Preventive medicine, established patient, age 12-17

$62K

1,015 claims · 0.8%

Your Cost: $61.05/claim|Median: $80.15
0.8× median
99490Top 10%

Chronic care management services, 20 minutes per month

$62K

2,094 claims · 0.7%

Your Cost: $29.46/claim|Median: $6.31
4.7× median
D0274Normal range

Bitewings, four radiographic images

$61K

3,060 claims · 0.7%

Your Cost: $19.94/claim|Median: $22.54
0.9× median
← All providersHow we detect fraud →