Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

⚖️ Compare🖨️ Print Report

SENTARA MEDICAL GROUP

Family Medicine·NORFOLK, VA·NPI: 1265485270Share

Compared to Family Medicine Peers

Total spending distribution among 19 providers in this specialty

P25MedianP75P90

This provider's total spending of $48.8M is at the 75th percentile among 19 Family Medicine providers.

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

Total Paid

$48.8M

$48,767,306

Total Claims

1.5M

Beneficiaries

1.2M

1.2 claims/patient

Avg Cost/Claim

$33

Monthly Spending Trend

Yearly Spending

2018
$2.4M
+117%
2019
$5.1M
+14%
2020
$5.8M
+31%
2021
$7.6M
+9%
2022
$8.3M
+22%
2023
$10.1M
-7%
2024
$9.4M

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 40% of total spending.

99214Normal range

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

$19.3M

319K claims · 39.5%

Your Cost: $60.32/claim|Median: $53.41
1.1× median
99213Normal range

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

$5.9M

132K claims · 12.2%

Your Cost: $45.08/claim|Median: $37.81
1.2× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$3.8M

129K claims · 7.8%

Your Cost: $29.54/claim|Median: $23.99
1.2× median
99233Normal range

Subsequent hospital care, per day, high complexity

$3.4M

69K claims · 6.9%

Your Cost: $48.53/claim|Median: $35.30
1.4× median
99223Normal range

Initial hospital care, per day, high complexity

$2.0M

25K claims · 4.1%

Your Cost: $79.45/claim|Median: $67.32
1.2× median
93306Normal range

Echocardiography, transthoracic, complete, with Doppler

$1.8M

43K claims · 3.7%

Your Cost: $41.21/claim|Median: $54.68
0.8× median
90833Normal range

Psychotherapy, 30 min, add-on to E/M service

$1.4M

31K claims · 3.0%

Your Cost: $46.57/claim|Median: $38.83
1.2× median
99291Normal range

Critical care, first 30-74 minutes

$897K

10K claims · 1.8%

Your Cost: $87.84/claim|Median: $101.24
0.9× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$865K

17K claims · 1.8%

Your Cost: $51.05/claim|Median: $43.85
1.2× median
99392Normal range

Preventive medicine, established patient, age 1-4

$808K

11K claims · 1.7%

Your Cost: $75.89/claim|Median: $75.18
1.0× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$779K

7,332 claims · 1.6%

Your Cost: $106.30/claim|Median: $108.91
1.0× median
99215Normal range

Office/outpatient visit, high complexity

$754K

9,546 claims · 1.5%

Your Cost: $78.99/claim|Median: $74.09
1.1× median
99204Normal range

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

$583K

7,153 claims · 1.2%

Your Cost: $81.52/claim|Median: $84.03
1.0× median
99203Normal range

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

$505K

9,018 claims · 1.0%

Your Cost: $56.04/claim|Median: $57.85
1.0× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$497K

7,590 claims · 1.0%

Your Cost: $65.49/claim|Median: $69.35
0.9× median
99393Normal range

Preventive medicine, established patient, age 5-11

$491K

6,423 claims · 1.0%

Your Cost: $76.49/claim|Median: $74.82
1.0× median
J0585Normal range

Injection, onabotulinumtoxinA, 1 unit

$355K

810 claims · 0.7%

Your Cost: $438.64/claim|Median: $470.36
0.9× median
93970Normal range

Duplex scan of extremity veins, complete, bilateral

$355K

17K claims · 0.7%

Your Cost: $21.41/claim|Median: $43.07
0.5× median
99222Normal range

Initial hospital care, per day, moderate complexity

$317K

6,045 claims · 0.7%

Your Cost: $52.48/claim|Median: $51.25
1.0× median
93971Normal range

Duplex scan of extremity veins, unilateral or limited

$307K

19K claims · 0.6%

Your Cost: $15.89/claim|Median: $25.43
0.6× median
36415Normal range

Collection of venous blood by venipuncture

$206K

100K claims · 0.4%

Your Cost: $2.06/claim|Median: $1.57
1.3× median
99231Normal range

Subsequent hospital care, per day, low complexity

$193K

13K claims · 0.4%

Your Cost: $14.84/claim|Median: $16.77
0.9× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$192K

1,567 claims · 0.4%

Your Cost: $122.34/claim|Median: $111.09
1.1× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$191K

15K claims · 0.4%

Your Cost: $12.44/claim|Median: $7.18
1.7× median
99199Normal range

Unlisted special service, procedure, or report

$172K

54K claims · 0.4%

Your Cost: $3.19/claim|Median: $5.39
0.6× median
99394Normal range

Preventive medicine, established patient, age 12-17

$164K

1,986 claims · 0.3%

Your Cost: $82.62/claim|Median: $80.15
1.0× median
99396Normal range

Preventive medicine, established patient, age 40-64

$145K

1,678 claims · 0.3%

Your Cost: $86.35/claim|Median: $76.06
1.1× median
99395Normal range

Preventive medicine, established patient, age 18-39

$134K

1,694 claims · 0.3%

Your Cost: $79.35/claim|Median: $72.71
1.1× median
90834Normal range

Psychotherapy, 45 minutes

$109K

1,794 claims · 0.2%

Your Cost: $60.64/claim|Median: $63.65
1.0× median
99212Normal range

Office/outpatient visit, low complexity

$108K

5,055 claims · 0.2%

Your Cost: $21.46/claim|Median: $25.06
0.9× median
93880Normal range

Duplex ultrasound scan of carotid arteries, bilateral

$93K

3,795 claims · 0.2%

Your Cost: $24.57/claim|Median: $49.03
0.5× median
73630Top 25%

X-ray, foot, complete, minimum 3 views

$83K

3,975 claims · 0.2%

Your Cost: $20.78/claim|Median: $12.06
1.7× median
93975Normal range

Duplex scan of arterial inflow and venous outflow, complete

$77K

2,262 claims · 0.2%

Your Cost: $34.10/claim|Median: $79.28
0.4× median
93000Normal range

Electrocardiogram, complete, with interpretation and report

$76K

8,510 claims · 0.2%

Your Cost: $8.90/claim|Median: $9.70
0.9× median
90791Normal range

Psychiatric diagnostic evaluation

$71K

662 claims · 0.1%

Your Cost: $106.69/claim|Median: $99.21
1.1× median
78452Normal range

Myocardial perfusion imaging, SPECT, multiple studies

$69K

1,308 claims · 0.1%

Your Cost: $53.04/claim|Median: $106.14
0.5× median
90670Top 25%

$66K

4,464 claims · 0.1%

Your Cost: $14.68/claim|Median: $5.94
2.5× median
90471Normal range

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$64K

9,959 claims · 0.1%

Your Cost: $6.45/claim|Median: $9.80
0.7× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$59K

4,731 claims · 0.1%

Your Cost: $12.57/claim|Median: $11.48
1.1× median
95816Normal range

$57K

2,106 claims · 0.1%

Your Cost: $26.95/claim|Median: $56.87
0.5× median
64615Normal range

$56K

627 claims · 0.1%

Your Cost: $89.45/claim|Median: $82.82
1.1× median
93922Normal range

$54K

3,402 claims · 0.1%

Your Cost: $15.75/claim|Median: $26.06
0.6× median
87804Normal range

Influenza virus detection, rapid test

$53K

4,098 claims · 0.1%

Your Cost: $12.95/claim|Median: $12.59
1.0× median
95819Normal range

Electroencephalogram with sleep recording

$50K

1,593 claims · 0.1%

Your Cost: $31.52/claim|Median: $62.75
0.5× median
90837Normal range

Psychotherapy, 60 minutes

$45K

495 claims · 0.1%

Your Cost: $90.47/claim|Median: $85.66
1.1× median
64400Normal range

$45K

1,018 claims · 0.1%

Your Cost: $43.74/claim|Median: $114.91
0.4× median
93295Normal range

$36K

1,896 claims · 0.1%

Your Cost: $19.00/claim|Median: $21.14
0.9× median
3074FNormal range

$35K

53K claims · 0.1%

Your Cost: $0.66/claim|Median: $0.11
6.0× median
90698Normal range

$35K

2,805 claims · 0.1%

Your Cost: $12.47/claim|Median: $6.32
2.0× median
93923Normal range

$35K

1,764 claims · 0.1%

Your Cost: $19.81/claim|Median: $38.08
0.5× median

Other Top Providers in Virginia

View all →

Virginia Commonwealth University Health System Authority

General Acute Care Hospital

$658.5M

Rector & Visitors of the University of Virginia

General Acute Care Hospital

$500.5M

Wall Residences LLC

Community Based Residential Treatment Facility In

$481.6M

Home Care Delivered, Inc.

Durable Medical Equipment & Medical Supplies

$309.5M

Childrens Hospital of the Kings Daughters INC

Social Worker, Clinical

$288.2M

Similar Providers

Other top providers in Family Medicine

Dap Health, Inc.

El Cajon, CA

$270.2M

Adelante Healthcare, Inc.

Phoenix, AZ

$245.9M

Fast Pace Medical Clinic PLLC

Spring Hill, TN

$179.4M

← All providersAll providers in Virginia →How we detect fraud →