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

⚖️ Compare🖨️ Print Report

COMMUNITY MEDICINE ASSOCIATES

Family Medicine·SAN ANTONIO, TX·NPI: 1245313329Share

Compared to Family Medicine Peers

Total spending distribution among 19 providers in this specialty

P25MedianP75P90

This provider's total spending of $37.4M is at the 75th percentile among 19 Family Medicine providers.

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

Total Paid

$37.4M

$37,381,052

Total Claims

1.8M

Beneficiaries

1.6M

1.1 claims/patient

Avg Cost/Claim

$21

Monthly Spending Trend

Yearly Spending

2018
$273K
-7%
2019
$254K
+427%
2020
$1.3M
+428%
2021
$7.1M
+44%
2022
$10.2M
+11%
2023
$11.3M
-39%
2024
$6.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 35% of total spending.

99214Normal range

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

$13.0M

236K claims · 34.7%

Your Cost: $54.97/claim|Median: $53.41
1.0× median
99213Normal range

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

$8.1M

175K claims · 21.6%

Your Cost: $45.97/claim|Median: $37.81
1.2× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$3.3M

43K claims · 8.7%

Your Cost: $75.18/claim|Median: $69.35
1.1× median
99392Normal range

Preventive medicine, established patient, age 1-4

$2.4M

30K claims · 6.4%

Your Cost: $78.51/claim|Median: $75.18
1.0× median
99469Normal range

Subsequent intensive care, very low birth weight infant

$1.8M

5,612 claims · 4.9%

Your Cost: $323.12/claim|Median: $293.45
1.1× median
99393Normal range

Preventive medicine, established patient, age 5-11

$1.4M

18K claims · 3.9%

Your Cost: $82.03/claim|Median: $74.82
1.1× median
99480Normal range

Subsequent intensive care, very low birth weight infant

$997K

9,516 claims · 2.7%

Your Cost: $104.78/claim|Median: $98.15
1.1× median
99050Top 5%

$982K

14K claims · 2.6%

Your Cost: $69.44/claim|Median: $11.81
5.9× median
99394Normal range

Preventive medicine, established patient, age 12-17

$844K

10K claims · 2.3%

Your Cost: $83.54/claim|Median: $80.15
1.0× median
99479Normal range

Subsequent intensive care, 2,501-5,000 grams

$712K

6,138 claims · 1.9%

Your Cost: $115.99/claim|Median: $103.70
1.1× median
99215Normal range

Office/outpatient visit, high complexity

$632K

6,647 claims · 1.7%

Your Cost: $95.08/claim|Median: $74.09
1.3× median
99203Normal range

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

$477K

7,183 claims · 1.3%

Your Cost: $66.47/claim|Median: $57.85
1.1× median
99204Normal range

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

$451K

5,004 claims · 1.2%

Your Cost: $90.20/claim|Median: $84.03
1.1× median
01967Normal range

Anesthesia, neuraxial labor analgesia/delivery

$257K

1,282 claims · 0.7%

Your Cost: $200.39/claim|Median: $283.78
0.7× median
99472Top 25%

Subsequent pediatric critical care, per day, age 2-5

$230K

613 claims · 0.6%

Your Cost: $375.98/claim|Median: $307.98
1.2× median
96110Normal range

Developmental screening, per standardized instrument

$226K

33K claims · 0.6%

Your Cost: $6.91/claim|Median: $9.10
0.8× median
92579Normal range

$163K

5,640 claims · 0.4%

Your Cost: $28.92/claim|Median: $30.58
0.9× median
99381Normal range

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

$159K

1,910 claims · 0.4%

Your Cost: $83.07/claim|Median: $73.46
1.1× median
99245Normal range

Office consultation, high complexity

$147K

949 claims · 0.4%

Your Cost: $154.66/claim|Median: $143.30
1.1× median
92587Normal range

$142K

10K claims · 0.4%

Your Cost: $13.60/claim|Median: $19.24
0.7× median
92567Normal range

$122K

14K claims · 0.3%

Your Cost: $8.44/claim|Median: $11.50
0.7× median
99212Normal range

Office/outpatient visit, low complexity

$121K

5,279 claims · 0.3%

Your Cost: $22.90/claim|Median: $25.06
0.9× median
90832Normal range

Psychotherapy, 30 minutes

$101K

2,762 claims · 0.3%

Your Cost: $36.67/claim|Median: $41.28
0.9× median
92557Normal range

Comprehensive audiometry, air, bone, and speech testing

$76K

3,160 claims · 0.2%

Your Cost: $24.03/claim|Median: $27.28
0.9× median
99383Normal range

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

$67K

754 claims · 0.2%

Your Cost: $88.68/claim|Median: $81.92
1.1× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$66K

547 claims · 0.2%

Your Cost: $121.21/claim|Median: $108.91
1.1× median
99395Normal range

Preventive medicine, established patient, age 18-39

$43K

671 claims · 0.1%

Your Cost: $63.76/claim|Median: $72.71
0.9× median
76830Normal range

Ultrasound, transvaginal

$32K

1,301 claims · 0.1%

Your Cost: $24.65/claim|Median: $57.47
0.4× median
96116Normal range

Neurobehavioral status examination, first hour

$32K

679 claims · 0.1%

Your Cost: $46.80/claim|Median: $46.64
1.0× median
92652Normal range

$27K

563 claims · 0.1%

Your Cost: $48.10/claim|Median: $72.54
0.7× median
95811Normal range

Sleep study with CPAP titration, polysomnography

$26K

308 claims · 0.1%

Your Cost: $84.20/claim|Median: $255.03
0.3× median
59430Normal range

$24K

301 claims · 0.1%

Your Cost: $81.21/claim|Median: $80.32
1.0× median
95810Normal range

Polysomnography, sleep study, 6+ hours

$24K

321 claims · 0.1%

Your Cost: $73.90/claim|Median: $233.73
0.3× median
99384Normal range

Preventive visit, new patient, adolescent (12-17 yr)

$23K

233 claims · 0.1%

Your Cost: $96.85/claim|Median: $83.63
1.2× median
97169Normal range

$22K

887 claims · 0.1%

Your Cost: $25.17/claim|Median: $22.00
1.1× median
11042Normal range

Debridement, subcutaneous tissue, first 20 sq cm

$22K

798 claims · 0.1%

Your Cost: $27.39/claim|Median: $36.13
0.8× median
69210Normal range

$19K

1,447 claims · 0.1%

Your Cost: $13.13/claim|Median: $21.74
0.6× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$18K

160 claims · 0.0%

Your Cost: $113.81/claim|Median: $111.09
1.0× median
92582Normal range

$12K

365 claims · 0.0%

Your Cost: $33.28/claim|Median: $46.66
0.7× median
99382Normal range

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

$11K

124 claims · 0.0%

Your Cost: $92.07/claim|Median: $79.89
1.2× median
99464Normal range

$10K

143 claims · 0.0%

Your Cost: $71.71/claim|Median: $59.94
1.2× median
99385Normal range

Preventive visit, new patient, 18-39 yr

$10K

142 claims · 0.0%

Your Cost: $71.77/claim|Median: $76.22
0.9× median
90833Top 25%

Psychotherapy, 30 min, add-on to E/M service

$10K

162 claims · 0.0%

Your Cost: $61.30/claim|Median: $38.83
1.6× median
01961Normal range

$10K

45 claims · 0.0%

Your Cost: $212.09/claim|Median: $156.02
1.4× median
99239Top 25%

Hospital discharge day management, more than 30 minutes

$9K

120 claims · 0.0%

Your Cost: $73.33/claim|Median: $43.85
1.7× median
90791Normal range

Psychiatric diagnostic evaluation

$9K

107 claims · 0.0%

Your Cost: $80.64/claim|Median: $99.21
0.8× median
76801Normal range

Ultrasound, pregnant uterus, single fetus, first trimester

$8K

241 claims · 0.0%

Your Cost: $34.84/claim|Median: $58.16
0.6× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$5K

139 claims · 0.0%

Your Cost: $36.88/claim|Median: $40.11
0.9× median
99233Top 25%

Subsequent hospital care, per day, high complexity

$5K

81 claims · 0.0%

Your Cost: $60.19/claim|Median: $35.30
1.7× median
99417Normal range

$4K

393 claims · 0.0%

Your Cost: $11.44/claim|Median: $34.90
0.3× median

Other Top Providers in Texas

View all →

Girling Health Care Inc.

Home Health

$858.2M

Aoc TX LLC

Home Health

$708.5M

Consumer Directed Services in Texas Inc.

Supports Brokerage

$624.8M

Caregivers Home Health TX INC

Nursing Care

$477.7M

Legacy Community Health Services, INC

Pediatrics

$406.5M

Similar Providers

Other top providers in Family Medicine

Dap Health, Inc.

El Cajon, CA

$270.2M

Adelante Healthcare, Inc.

Phoenix, AZ

$245.9M

Fast Pace Medical Clinic PLLC

Spring Hill, TN

$179.4M

← All providersAll providers in Texas →How we detect fraud →