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Provider 1255352266

NPI: 1255352266Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$9.2M

$9,226,797

Total Claims

176K

Beneficiaries

151K

1.2 claims/patient

Avg Cost/Claim

$52

Monthly Spending Trend

Yearly Spending

2018
$1.2M
-7%
2019
$1.1M
-26%
2020
$815K
+29%
2021
$1.1M
+66%
2022
$1.8M
-5%
2023
$1.7M
+0%
2024
$1.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 29 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 19% of total spending.

99213Normal range

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

$1.7M

37K claims · 18.5%

Your Cost: $46.31/claim|Median: $37.81
1.2× median
42820Normal range

Tonsillectomy and adenoidectomy, under age 12

$1.4M

5,934 claims · 15.4%

Your Cost: $240.21/claim|Median: $331.68
0.7× median
69436Normal range

Tympanostomy, general anesthesia

$1.4M

8,751 claims · 15.4%

Your Cost: $162.46/claim|Median: $205.50
0.8× median
99204Top 25%

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

$755K

6,410 claims · 8.2%

Your Cost: $117.74/claim|Median: $84.03
1.4× median
99243Normal range

Office or other outpatient consultation, low complexity

$675K

7,299 claims · 7.3%

Your Cost: $92.45/claim|Median: $82.43
1.1× median
92567Normal range

$665K

49K claims · 7.2%

Your Cost: $13.45/claim|Median: $11.50
1.2× median
99203Normal range

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

$630K

8,733 claims · 6.8%

Your Cost: $72.12/claim|Median: $57.85
1.2× median
99214Normal range

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

$483K

7,282 claims · 5.2%

Your Cost: $66.28/claim|Median: $53.41
1.2× median
92587Top 25%

$257K

8,145 claims · 2.8%

Your Cost: $31.57/claim|Median: $19.24
1.6× median
92579Normal range

$222K

8,181 claims · 2.4%

Your Cost: $27.15/claim|Median: $30.58
0.9× median
99244Normal range

Office or other outpatient consultation, moderate complexity

$193K

1,635 claims · 2.1%

Your Cost: $118.08/claim|Median: $121.58
1.0× median
42830Normal range

$165K

2,053 claims · 1.8%

Your Cost: $80.48/claim|Median: $341.04
0.2× median
99212Normal range

Office/outpatient visit, low complexity

$149K

4,926 claims · 1.6%

Your Cost: $30.18/claim|Median: $25.06
1.2× median
92582Normal range

$103K

2,985 claims · 1.1%

Your Cost: $34.45/claim|Median: $46.66
0.7× median
92555Normal range

$89K

6,253 claims · 1.0%

Your Cost: $14.22/claim|Median: $14.17
1.0× median
92552Normal range

Pure tone audiometry, air only, each ear

$85K

4,674 claims · 0.9%

Your Cost: $18.10/claim|Median: $12.63
1.4× median
31231Normal range

Nasal endoscopy, diagnostic

$79K

1,929 claims · 0.9%

Your Cost: $41.03/claim|Median: $98.77
0.4× median
92556Normal range

$53K

2,391 claims · 0.6%

Your Cost: $22.11/claim|Median: $24.07
0.9× median
92557Normal range

Comprehensive audiometry, air, bone, and speech testing

$34K

1,491 claims · 0.4%

Your Cost: $22.76/claim|Median: $27.28
0.8× median
92583Normal range

$11K

380 claims · 0.1%

Your Cost: $30.01/claim|Median: $27.53
1.1× median
40819Normal range

$6K

86 claims · 0.1%

Your Cost: $73.24/claim|Median: $159.02
0.5× median
31575Normal range

$5K

58 claims · 0.1%

Your Cost: $81.83/claim|Median: $68.78
1.2× median
41010Normal range

$4K

29 claims · 0.0%

Your Cost: $125.23/claim|Median: $143.34
0.9× median
42821Normal range

$4K

14 claims · 0.0%

Your Cost: $250.41/claim|Median: $613.18
0.4× median
95117Normal range

$2K

220 claims · 0.0%

Your Cost: $7.92/claim|Median: $8.34
0.9× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$2K

33 claims · 0.0%

Your Cost: $45.59/claim|Median: $40.11
1.1× median
92553Normal range

$387

17 claims · 0.0%

Your Cost: $22.77/claim|Median: $20.30
1.1× median
92504Normal range

$87

20 claims · 0.0%

Your Cost: $4.37/claim|Median: $16.07
0.3× median
G8427Normal range

$0

20 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.02
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