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Provider 1265429658

NPI: 1265429658Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$8.0M

$7,955,928

Total Claims

169K

Beneficiaries

156K

1.1 claims/patient

Avg Cost/Claim

$47

Monthly Spending Trend

Yearly Spending

2018
$865K
+68%
2019
$1.5M
-8%
2020
$1.3M
-6%
2021
$1.3M
-28%
2022
$905K
+14%
2023
$1.0M
+8%
2024
$1.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 20 distinct procedure codes. The top code (92004 (Ophthalmological exam, comprehensive, new patient)) accounts for 28% of total spending.

92004Top 25%

Ophthalmological exam, comprehensive, new patient

$2.3M

20K claims · 28.3%

Your Cost: $110.33/claim|Median: $59.72
1.8× median
92014Top 25%

Ophthalmological exam, comprehensive, established patient

$1.7M

19K claims · 21.3%

Your Cost: $89.75/claim|Median: $47.08
1.9× median
V2020Top 25%

Frames, purchases

$1.5M

43K claims · 19.2%

Your Cost: $35.25/claim|Median: $19.33
1.8× median
V2103Top 10%

Lens, sphere-cylinder, single vision, plus or minus 4.00

$877K

19K claims · 11.0%

Your Cost: $45.31/claim|Median: $18.82
2.4× median
92015Normal range

Determination of refractive state

$676K

47K claims · 8.5%

Your Cost: $14.44/claim|Median: $10.36
1.4× median
V2100Top 10%

Lens, sphere, single vision, plus or minus 4.00

$265K

6,436 claims · 3.3%

Your Cost: $41.20/claim|Median: $20.68
2.0× median
V2410Top 10%

$181K

1,104 claims · 2.3%

Your Cost: $163.90/claim|Median: $86.18
1.9× median
V2755Top 25%

$130K

5,158 claims · 1.6%

Your Cost: $25.22/claim|Median: $12.60
2.0× median
V2203Top 25%

$122K

2,227 claims · 1.5%

Your Cost: $54.58/claim|Median: $29.84
1.8× median
V2104Top 25%

$87K

2,200 claims · 1.1%

Your Cost: $39.45/claim|Median: $16.70
2.4× median
99213Top 25%

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

$82K

1,459 claims · 1.0%

Your Cost: $56.02/claim|Median: $37.81
1.5× median
V2200Top 25%

$32K

663 claims · 0.4%

Your Cost: $48.70/claim|Median: $28.94
1.7× median
V2107Top 25%

$10K

248 claims · 0.1%

Your Cost: $40.14/claim|Median: $17.55
2.3× median
V2784Top 5%

Lens, polycarbonate or equal

$8K

155 claims · 0.1%

Your Cost: $48.45/claim|Median: $9.50
5.1× median
92002Normal range

Intermediate eye exam, new patient

$7K

411 claims · 0.1%

Your Cost: $17.10/claim|Median: $41.61
0.4× median
92133Top 25%

$3K

123 claims · 0.0%

Your Cost: $28.38/claim|Median: $19.09
1.5× median
V2105Top 25%

$1K

31 claims · 0.0%

Your Cost: $41.55/claim|Median: $23.98
1.7× median
92012Normal range

Ophthalmological exam, intermediate, established patient

$862

167 claims · 0.0%

Your Cost: $5.16/claim|Median: $38.23
0.1× median
92083Top 25%

Visual field exam, extended testing, bilateral

$678

14 claims · 0.0%

Your Cost: $48.40/claim|Median: $29.82
1.6× median
92310Normal range

$111

13 claims · 0.0%

Your Cost: $8.54/claim|Median: $35.49
0.2× median
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