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Provider 1255437166

NPI: 1255437166Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$7.9M

$7,939,520

Total Claims

148K

Beneficiaries

142K

1.0 claims/patient

Avg Cost/Claim

$54

Monthly Spending Trend

Yearly Spending

2018
$546K
+61%
2019
$878K
+5%
2020
$926K
+47%
2021
$1.4M
+8%
2022
$1.5M
+16%
2023
$1.7M
-38%
2024
$1.1M

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 34% of total spending.

99214Top 10%

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

$2.7M

24K claims · 33.8%

Your Cost: $113.10/claim|Median: $53.41
2.1× median
99213Top 10%

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

$1.6M

21K claims · 20.6%

Your Cost: $78.54/claim|Median: $37.81
2.1× median
88305Top 5%

Surgical pathology, gross and microscopic examination

$867K

4,921 claims · 10.9%

Your Cost: $176.19/claim|Median: $35.80
4.9× median
43239Top 25%

Upper GI endoscopy with biopsy

$252K

860 claims · 3.2%

Your Cost: $292.62/claim|Median: $151.68
1.9× median
99221Top 10%

Initial hospital care, straightforward/low

$246K

2,531 claims · 3.1%

Your Cost: $97.22/claim|Median: $39.96
2.4× median
99204Top 5%

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

$219K

1,341 claims · 2.8%

Your Cost: $163.60/claim|Median: $84.03
1.9× median
88312Top 10%

$218K

2,168 claims · 2.7%

Your Cost: $100.54/claim|Median: $24.56
4.1× median
99393Top 25%

Preventive medicine, established patient, age 5-11

$207K

2,159 claims · 2.6%

Your Cost: $95.86/claim|Median: $74.82
1.3× median
99392Top 25%

Preventive medicine, established patient, age 1-4

$156K

1,612 claims · 2.0%

Your Cost: $96.63/claim|Median: $75.18
1.3× median
A4550Top 10%

$137K

693 claims · 1.7%

Your Cost: $197.51/claim|Median: $4.85
40.7× median
99394Top 25%

Preventive medicine, established patient, age 12-17

$128K

1,226 claims · 1.6%

Your Cost: $104.47/claim|Median: $80.15
1.3× median
93306Top 25%

Echocardiography, transthoracic, complete, with Doppler

$116K

805 claims · 1.5%

Your Cost: $144.53/claim|Median: $54.68
2.6× median
99391Top 25%

Preventive medicine, established patient, infant (under 1)

$113K

1,239 claims · 1.4%

Your Cost: $90.86/claim|Median: $69.35
1.3× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$107K

7,843 claims · 1.3%

Your Cost: $13.61/claim|Median: $17.85
0.8× median
99203Top 10%

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

$101K

921 claims · 1.3%

Your Cost: $109.79/claim|Median: $57.85
1.9× median
93000Top 25%

Electrocardiogram, complete, with interpretation and report

$79K

5,411 claims · 1.0%

Your Cost: $14.68/claim|Median: $9.70
1.5× median
00731Top 25%

$55K

438 claims · 0.7%

Your Cost: $125.06/claim|Median: $64.75
1.9× median
93010Top 25%

Electrocardiogram, interpretation and report only

$47K

5,917 claims · 0.6%

Your Cost: $7.99/claim|Median: $5.60
1.4× median
99215Top 5%

Office/outpatient visit, high complexity

$43K

252 claims · 0.5%

Your Cost: $171.52/claim|Median: $74.09
2.3× median
99223Top 5%

Initial hospital care, per day, high complexity

$43K

258 claims · 0.5%

Your Cost: $165.42/claim|Median: $67.32
2.5× median
99211Top 25%

Office/outpatient visit, minimal complexity

$33K

1,380 claims · 0.4%

Your Cost: $24.25/claim|Median: $12.93
1.9× median
81003Normal range

Urinalysis, automated without microscopy

$30K

15K claims · 0.4%

Your Cost: $2.03/claim|Median: $1.48
1.4× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$29K

612 claims · 0.4%

Your Cost: $48.19/claim|Median: $39.70
1.2× median
G0008Top 25%

$28K

1,930 claims · 0.4%

Your Cost: $14.67/claim|Median: $2.54
5.8× median
45380Normal range

Colonoscopy with biopsy

$27K

86 claims · 0.3%

Your Cost: $308.90/claim|Median: $200.68
1.5× median
87804Normal range

Influenza virus detection, rapid test

$25K

1,457 claims · 0.3%

Your Cost: $17.03/claim|Median: $12.59
1.4× median
99222Top 5%

Initial hospital care, per day, moderate complexity

$23K

171 claims · 0.3%

Your Cost: $135.17/claim|Median: $51.25
2.6× median
99232Top 5%

Subsequent hospital care, per day, moderate complexity

$23K

320 claims · 0.3%

Your Cost: $71.15/claim|Median: $23.99
3.0× median
51798Top 25%

$20K

1,586 claims · 0.3%

Your Cost: $12.87/claim|Median: $6.59
2.0× median
99233Top 5%

Subsequent hospital care, per day, high complexity

$19K

190 claims · 0.2%

Your Cost: $102.44/claim|Median: $35.30
2.9× median
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