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PRIMA CARE, PC

Clinic/Center·FALL RIVER, MA·NPI: 1265422596Share

Compared to Clinic/Center Peers

Total spending distribution among 13 providers in this specialty

P25MedianP75P90

This provider's total spending of $32.4M is at the 50th percentile among 13 Clinic/Center providers.

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

Total Paid

$32.4M

$32,393,532

Total Claims

1.6M

Beneficiaries

1.4M

1.2 claims/patient

Avg Cost/Claim

$20

Monthly Spending Trend

Yearly Spending

2018
$5.3M
-6%
2019
$5.0M
-15%
2020
$4.2M
+19%
2021
$5.0M
+8%
2022
$5.4M
-22%
2023
$4.2M
-21%
2024
$3.3M

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 22% of total spending.

99214Normal range

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

$7.1M

184K claims · 21.8%

Your Cost: $38.42/claim|Median: $53.41
0.7× median
99213Normal range

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

$4.0M

128K claims · 12.4%

Your Cost: $31.29/claim|Median: $37.81
0.8× median
99233Normal range

Subsequent hospital care, per day, high complexity

$2.5M

83K claims · 7.8%

Your Cost: $30.46/claim|Median: $35.30
0.9× median
99223Normal range

Initial hospital care, per day, high complexity

$1.9M

29K claims · 5.9%

Your Cost: $67.32/claim|Median: $67.32
1.0× median
99215Normal range

Office/outpatient visit, high complexity

$920K

20K claims · 2.8%

Your Cost: $46.14/claim|Median: $74.09
0.6× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$887K

44K claims · 2.7%

Your Cost: $20.32/claim|Median: $23.99
0.8× median
97110Normal range

Therapeutic exercises, each 15 min

$795K

39K claims · 2.5%

Your Cost: $20.42/claim|Median: $24.49
0.8× median
93306Normal range

Echocardiography, transthoracic, complete, with Doppler

$745K

17K claims · 2.3%

Your Cost: $42.71/claim|Median: $54.68
0.8× median
77067Normal range

Screening mammography, bilateral, including CAD

$601K

13K claims · 1.9%

Your Cost: $44.75/claim|Median: $39.33
1.1× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$549K

17K claims · 1.7%

Your Cost: $33.00/claim|Median: $43.85
0.8× median
99204Normal range

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

$545K

6,503 claims · 1.7%

Your Cost: $83.78/claim|Median: $84.03
1.0× median
99203Normal range

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

$491K

9,174 claims · 1.5%

Your Cost: $53.56/claim|Median: $57.85
0.9× median
43239Normal range

Upper GI endoscopy with biopsy

$446K

4,613 claims · 1.4%

Your Cost: $96.77/claim|Median: $151.68
0.6× median
95180Normal range

$442K

3,300 claims · 1.4%

Your Cost: $133.95/claim|Median: $156.79
0.9× median
99396Normal range

Preventive medicine, established patient, age 40-64

$325K

4,159 claims · 1.0%

Your Cost: $78.16/claim|Median: $76.06
1.0× median
71250Normal range

CT scan of chest without contrast

$256K

5,379 claims · 0.8%

Your Cost: $47.56/claim|Median: $39.11
1.2× median
92014Normal range

Ophthalmological exam, comprehensive, established patient

$250K

7,514 claims · 0.8%

Your Cost: $33.25/claim|Median: $47.08
0.7× median
95165Normal range

Professional services for allergen immunotherapy, per injection

$241K

1,527 claims · 0.7%

Your Cost: $157.85/claim|Median: $144.04
1.1× median
98941Normal range

Chiropractic manipulative treatment, 3-4 spinal regions

$239K

11K claims · 0.7%

Your Cost: $22.16/claim|Median: $20.83
1.1× median
88305Normal range

Surgical pathology, gross and microscopic examination

$225K

4,369 claims · 0.7%

Your Cost: $51.59/claim|Median: $35.80
1.4× median
99291Normal range

Critical care, first 30-74 minutes

$224K

2,631 claims · 0.7%

Your Cost: $85.28/claim|Median: $101.24
0.8× median
82306Normal range

Vitamin D, 25 hydroxy

$224K

14K claims · 0.7%

Your Cost: $15.47/claim|Median: $18.18
0.9× median
92340Top 25%

Fitting of spectacles, except for aphakia

$220K

8,116 claims · 0.7%

Your Cost: $27.13/claim|Median: $19.46
1.4× median
76700Normal range

Ultrasound, abdominal, complete

$216K

5,457 claims · 0.7%

Your Cost: $39.50/claim|Median: $50.69
0.8× median
J0897Normal range

Injection, denosumab, one milligram

$205K

823 claims · 0.6%

Your Cost: $248.86/claim|Median: $493.25
0.5× median
77063Normal range

Screening digital breast tomosynthesis, bilateral

$201K

13K claims · 0.6%

Your Cost: $15.27/claim|Median: $21.41
0.7× median
80050Normal range

General health panel

$196K

12K claims · 0.6%

Your Cost: $16.66/claim|Median: $25.59
0.7× median
99309Normal range

Nursing facility care, subsequent, low complexity

$187K

20K claims · 0.6%

Your Cost: $9.55/claim|Median: $14.00
0.7× median
99308Normal range

Nursing facility care, subsequent, straightforward

$179K

26K claims · 0.6%

Your Cost: $7.03/claim|Median: $9.79
0.7× median
78452Normal range

Myocardial perfusion imaging, SPECT, multiple studies

$175K

1,805 claims · 0.5%

Your Cost: $96.79/claim|Median: $106.14
0.9× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$167K

1,746 claims · 0.5%

Your Cost: $95.54/claim|Median: $111.09
0.9× median
99212Normal range

Office/outpatient visit, low complexity

$163K

8,133 claims · 0.5%

Your Cost: $20.06/claim|Median: $25.06
0.8× median
71046Normal range

Chest X-ray, 2 views

$151K

15K claims · 0.5%

Your Cost: $10.06/claim|Median: $8.92
1.1× median
83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$150K

36K claims · 0.5%

Your Cost: $4.18/claim|Median: $5.50
0.8× median
99222Normal range

Initial hospital care, per day, moderate complexity

$150K

3,267 claims · 0.5%

Your Cost: $45.82/claim|Median: $51.25
0.9× median
95810Normal range

Polysomnography, sleep study, 6+ hours

$147K

783 claims · 0.5%

Your Cost: $188.35/claim|Median: $233.73
0.8× median
99211Normal range

Office/outpatient visit, minimal complexity

$146K

9,339 claims · 0.4%

Your Cost: $15.60/claim|Median: $12.93
1.2× median
95004Normal range

Percutaneous allergy skin tests, each

$138K

959 claims · 0.4%

Your Cost: $143.83/claim|Median: $134.97
1.1× median
45385Normal range

Colonoscopy with polyp removal, snare technique

$128K

851 claims · 0.4%

Your Cost: $150.49/claim|Median: $255.17
0.6× median
76536Normal range

$124K

3,359 claims · 0.4%

Your Cost: $36.89/claim|Median: $44.06
0.8× median
92015Normal range

Determination of refractive state

$121K

9,712 claims · 0.4%

Your Cost: $12.49/claim|Median: $10.36
1.2× median
45378Normal range

Colonoscopy, diagnostic

$116K

761 claims · 0.4%

Your Cost: $152.99/claim|Median: $225.49
0.7× median
85025Normal range

Complete blood count (CBC) with differential, automated

$114K

43K claims · 0.4%

Your Cost: $2.66/claim|Median: $4.71
0.6× median
92004Normal range

Ophthalmological exam, comprehensive, new patient

$111K

2,100 claims · 0.3%

Your Cost: $53.03/claim|Median: $59.72
0.9× median
00812Normal range

$111K

1,512 claims · 0.3%

Your Cost: $73.44/claim|Median: $59.54
1.2× median
U0003Normal range

Infectious disease detection (COVID-19)

$105K

2,001 claims · 0.3%

Your Cost: $52.67/claim|Median: $63.08
0.8× median
93000Normal range

Electrocardiogram, complete, with interpretation and report

$105K

13K claims · 0.3%

Your Cost: $7.92/claim|Median: $9.70
0.8× median
84443Normal range

Thyroid stimulating hormone (TSH)

$104K

23K claims · 0.3%

Your Cost: $4.54/claim|Median: $9.87
0.5× median
74177Normal range

CT abdomen and pelvis with contrast

$101K

1,043 claims · 0.3%

Your Cost: $96.98/claim|Median: $65.76
1.5× median
45380Normal range

Colonoscopy with biopsy

$94K

631 claims · 0.3%

Your Cost: $148.43/claim|Median: $200.68
0.7× median

Other Top Providers in Massachusetts

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Tempus Unlimited, Inc.

Voluntary or Charitable

$5.57B

Department of Developmental Services

Case Management

$1.35B

Commonwealth of Massachusets

Case Management

$1.14B

Commonwealth of Mass-dds

Case Management

$1.10B

Stavros Center for Independent Living Inc.

Case Management

$1.04B

Similar Providers

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Children's Hospital Corporation

Boston, MA

$330.8M

County of Santa Cruz

Santa Cruz, CA

$276.3M

Northern Valley Indian Health INC

Willows, CA

$217.1M

Upmc Presbyterian Shadyside

Pittsburgh, PA

$125.5M

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