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Provider 1265489116

NPI: 1265489116Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$7.5M

$7,514,450

Total Claims

230K

Beneficiaries

222K

1.0 claims/patient

Avg Cost/Claim

$33

Monthly Spending Trend

Yearly Spending

2018
$1.1M
+1%
2019
$1.1M
-7%
2020
$1.0M
-14%
2021
$891K
+36%
2022
$1.2M
-3%
2023
$1.2M
-19%
2024
$962K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 28% of total spending.

99213Top 25%

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

$2.1M

39K claims · 27.8%

Your Cost: $53.80/claim|Median: $37.81
1.4× median
99214Top 25%

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

$1.1M

14K claims · 15.2%

Your Cost: $78.92/claim|Median: $53.41
1.5× median
99393Normal range

Preventive medicine, established patient, age 5-11

$633K

8,475 claims · 8.4%

Your Cost: $74.72/claim|Median: $74.82
1.0× median
99392Normal range

Preventive medicine, established patient, age 1-4

$581K

7,796 claims · 7.7%

Your Cost: $74.50/claim|Median: $75.18
1.0× median
99394Normal range

Preventive medicine, established patient, age 12-17

$580K

7,188 claims · 7.7%

Your Cost: $80.68/claim|Median: $80.15
1.0× median
99212Normal range

Office/outpatient visit, low complexity

$577K

16K claims · 7.7%

Your Cost: $36.64/claim|Median: $25.06
1.5× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$533K

23K claims · 7.1%

Your Cost: $22.90/claim|Median: $17.85
1.3× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$342K

5,042 claims · 4.6%

Your Cost: $67.85/claim|Median: $69.35
1.0× median
92583Normal range

$175K

5,255 claims · 2.3%

Your Cost: $33.36/claim|Median: $27.53
1.2× median
92551Top 25%

Screening audiometry, pure tone, air only

$147K

15K claims · 2.0%

Your Cost: $9.88/claim|Median: $6.61
1.5× median
97802Normal range

Medical nutrition therapy, reassessment, individual, fifteen minutes

$145K

15K claims · 1.9%

Your Cost: $9.53/claim|Median: $12.70
0.8× median
90461Normal range

Immunization admin, additional vaccine, counseling

$106K

7,596 claims · 1.4%

Your Cost: $14.00/claim|Median: $6.93
2.0× median
99395Normal range

Preventive medicine, established patient, age 18-39

$63K

804 claims · 0.8%

Your Cost: $77.78/claim|Median: $72.71
1.1× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$55K

5,199 claims · 0.7%

Your Cost: $10.59/claim|Median: $11.48
0.9× median
99381Normal range

Preventive visit, new patient, infant (<1 yr)

$38K

569 claims · 0.5%

Your Cost: $67.22/claim|Median: $73.46
0.9× median
90620Top 25%

$33K

1,269 claims · 0.4%

Your Cost: $26.36/claim|Median: $6.49
4.1× median
99173Normal range

$32K

18K claims · 0.4%

Your Cost: $1.80/claim|Median: $2.16
0.8× median
90651Normal range

HPV vaccine, 9-valent

$31K

1,675 claims · 0.4%

Your Cost: $18.49/claim|Median: $8.93
2.1× median
90670Normal range

$28K

3,387 claims · 0.4%

Your Cost: $8.14/claim|Median: $5.94
1.4× median
90734Top 25%

$26K

1,646 claims · 0.3%

Your Cost: $15.71/claim|Median: $6.40
2.5× median
90649Top 25%

$26K

758 claims · 0.3%

Your Cost: $34.12/claim|Median: $6.42
5.3× median
95930Top 25%

Visual evoked potential testing

$21K

394 claims · 0.3%

Your Cost: $53.18/claim|Median: $35.54
1.5× median
99383Normal range

Preventive visit, new patient, late childhood (5-11 yr)

$17K

208 claims · 0.2%

Your Cost: $83.17/claim|Median: $81.92
1.0× median
36415Normal range

Collection of venous blood by venipuncture

$15K

7,017 claims · 0.2%

Your Cost: $2.11/claim|Median: $1.57
1.3× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$8K

5,144 claims · 0.1%

Your Cost: $1.59/claim|Median: $7.18
0.2× median
92558Normal range

$7K

733 claims · 0.1%

Your Cost: $9.60/claim|Median: $6.67
1.4× median
94640Normal range

Pressurized or nonpressurized inhalation treatment

$7K

572 claims · 0.1%

Your Cost: $12.02/claim|Median: $10.88
1.1× median
90656Normal range

$7K

1,414 claims · 0.1%

Your Cost: $4.85/claim|Median: $8.67
0.6× median
90723Normal range

DTaP-HepB-IPV vaccine

$6K

1,760 claims · 0.1%

Your Cost: $3.44/claim|Median: $5.78
0.6× median
90633Normal range

$5K

1,992 claims · 0.1%

Your Cost: $2.36/claim|Median: $3.56
0.7× median
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