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Provider 1255469110

NPI: 1255469110Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$9.5M

$9,548,871

Total Claims

76K

Beneficiaries

73K

1.0 claims/patient

Avg Cost/Claim

$126

Monthly Spending Trend

Yearly Spending

2018
$1.8M
-18%
2019
$1.5M
+19%
2020
$1.8M
+16%
2021
$2.1M
-31%
2022
$1.4M
-57%
2023
$622K
-58%
2024
$259K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 25 distinct procedure codes. The top code (S0199) accounts for 75% of total spending.

S0199Top 1%

$7.2M

8,911 claims · 74.9%

Your Cost: $803.14/claim|Median: $454.23
1.8× median
99215Normal range

Office/outpatient visit, high complexity

$1.0M

13K claims · 10.6%

Your Cost: $80.58/claim|Median: $74.09
1.1× median
76857Top 10%

Pelvic ultrasound, limited

$618K

9,772 claims · 6.5%

Your Cost: $63.20/claim|Median: $26.23
2.4× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$228K

1,681 claims · 2.4%

Your Cost: $135.59/claim|Median: $111.09
1.2× median
S4993Normal range

$140K

3,013 claims · 1.5%

Your Cost: $46.55/claim|Median: $46.61
1.0× median
J3490Top 25%

Unclassified drugs

$99K

3,337 claims · 1.0%

Your Cost: $29.72/claim|Median: $5.70
5.2× median
H0033Top 5%

Oral medication administration, direct observation

$59K

189 claims · 0.6%

Your Cost: $312.73/claim|Median: $31.37
10.0× median
A4267Top 25%

$56K

4,139 claims · 0.6%

Your Cost: $13.42/claim|Median: $7.86
1.7× median
81025Normal range

Urine pregnancy test

$43K

11K claims · 0.4%

Your Cost: $3.96/claim|Median: $4.81
0.8× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$34K

1,203 claims · 0.4%

Your Cost: $27.94/claim|Median: $40.11
0.7× median
86901Normal range

$31K

9,200 claims · 0.3%

Your Cost: $3.41/claim|Median: $2.26
1.5× median
85013Normal range

$26K

9,194 claims · 0.3%

Your Cost: $2.84/claim|Median: $2.44
1.2× median
99214Normal range

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

$11K

157 claims · 0.1%

Your Cost: $68.20/claim|Median: $53.41
1.3× median
S0190Top 5%

$9K

98 claims · 0.1%

Your Cost: $89.86/claim|Median: $58.42
1.5× median
99000Normal range

$5K

1,016 claims · 0.1%

Your Cost: $5.18/claim|Median: $2.30
2.3× median
Q0144Top 10%

$5K

140 claims · 0.0%

Your Cost: $33.84/claim|Median: $5.57
6.1× median
86328Top 10%

$4K

103 claims · 0.0%

Your Cost: $43.03/claim|Median: $20.52
2.1× median
86769Top 25%

Antibody, SARS-CoV-2 (COVID-19)

$3K

86 claims · 0.0%

Your Cost: $40.17/claim|Median: $26.94
1.5× median
J1000Top 1%

$3K

76 claims · 0.0%

Your Cost: $41.37/claim|Median: $16.03
2.6× median
99213Normal range

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

$2K

39 claims · 0.0%

Your Cost: $42.77/claim|Median: $37.81
1.1× median
87801Top 25%

Infectious agent detection, amplified probe, multiple organisms

$2K

28 claims · 0.0%

Your Cost: $54.04/claim|Median: $38.79
1.4× median
86900Normal range

$526

151 claims · 0.0%

Your Cost: $3.48/claim|Median: $2.55
1.4× median
85018Top 10%

$454

149 claims · 0.0%

Your Cost: $3.05/claim|Median: $1.71
1.8× median
S0191Top 25%

$59

16 claims · 0.0%

Your Cost: $3.70/claim|Median: $2.68
1.4× median
81005Top 10%

$43

16 claims · 0.0%

Your Cost: $2.66/claim|Median: $1.10
2.4× median
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