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PEDIATRIC GROUP OF ACADIANA, LLC

Specialist·LAFAYETTE, LA·NPI: 1265499628Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$57.6M

$57,578,421

Total Claims

2.3M

Beneficiaries

2.0M

1.2 claims/patient

Avg Cost/Claim

$25

Monthly Spending Trend

Yearly Spending

2018
$9.9M
+1%
2019
$10.0M
-24%
2020
$7.6M
+19%
2021
$9.1M
-7%
2022
$8.5M
-17%
2023
$7.0M
-21%
2024
$5.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 24% of total spending.

99213Normal range

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

$14.0M

326K claims · 24.3%

Your Cost: $43.01/claim|Median: $37.81
1.1× median
99214Normal range

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

$5.4M

95K claims · 9.3%

Your Cost: $56.30/claim|Median: $53.41
1.1× median
99212Normal range

Office/outpatient visit, low complexity

$4.3M

169K claims · 7.4%

Your Cost: $25.25/claim|Median: $25.06
1.0× median
99392Normal range

Preventive medicine, established patient, age 1-4

$4.1M

66K claims · 7.1%

Your Cost: $61.91/claim|Median: $75.18
0.8× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$3.5M

62K claims · 6.2%

Your Cost: $57.00/claim|Median: $69.35
0.8× median
99393Normal range

Preventive medicine, established patient, age 5-11

$3.4M

54K claims · 5.9%

Your Cost: $61.91/claim|Median: $74.82
0.8× median
99394Normal range

Preventive medicine, established patient, age 12-17

$2.7M

41K claims · 4.7%

Your Cost: $66.35/claim|Median: $80.15
0.8× median
90471Normal range

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

$1.7M

135K claims · 3.0%

Your Cost: $12.86/claim|Median: $9.80
1.3× median
87502Normal range

Influenza virus detection, reverse transcription, amplified probe

$1.6M

22K claims · 2.7%

Your Cost: $71.19/claim|Median: $65.64
1.1× median
95004Top 25%

Percutaneous allergy skin tests, each

$1.4M

6,103 claims · 2.5%

Your Cost: $232.39/claim|Median: $134.97
1.7× median
93303Normal range

Echocardiography, transthoracic, limited

$1.3M

11K claims · 2.2%

Your Cost: $110.88/claim|Median: $112.83
1.0× median
90472Normal range

Immunization administration, each additional vaccine

$1.2M

85K claims · 2.0%

Your Cost: $13.84/claim|Median: $11.79
1.2× median
54150Normal range

$835K

6,712 claims · 1.5%

Your Cost: $124.42/claim|Median: $84.60
1.5× median
92551Normal range

Screening audiometry, pure tone, air only

$753K

105K claims · 1.3%

Your Cost: $7.15/claim|Median: $6.61
1.1× median
99051Normal range

$690K

44K claims · 1.2%

Your Cost: $15.62/claim|Median: $7.89
2.0× median
99238Top 25%

Hospital discharge day management, 30 minutes or less

$637K

12K claims · 1.1%

Your Cost: $51.20/claim|Median: $37.22
1.4× median
99233Normal range

Subsequent hospital care, per day, high complexity

$611K

20K claims · 1.1%

Your Cost: $29.98/claim|Median: $35.30
0.8× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$494K

4,848 claims · 0.9%

Your Cost: $101.97/claim|Median: $111.09
0.9× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$494K

11K claims · 0.9%

Your Cost: $43.73/claim|Median: $62.48
0.7× median
87651Normal range

Streptococcus Group A detection, nucleic acid, amplified probe

$460K

15K claims · 0.8%

Your Cost: $29.97/claim|Median: $28.46
1.1× median
93320Normal range

$456K

11K claims · 0.8%

Your Cost: $39.70/claim|Median: $28.68
1.4× median
95165Normal range

Professional services for allergen immunotherapy, per injection

$448K

2,221 claims · 0.8%

Your Cost: $201.84/claim|Median: $144.04
1.4× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$420K

11K claims · 0.7%

Your Cost: $39.09/claim|Median: $39.70
1.0× median
99223Normal range

Initial hospital care, per day, high complexity

$406K

6,463 claims · 0.7%

Your Cost: $62.89/claim|Median: $67.32
0.9× median
99204Normal range

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

$352K

4,502 claims · 0.6%

Your Cost: $78.23/claim|Median: $84.03
0.9× median
0241UNormal range

Proprietary lab analysis, genomic sequencing

$348K

3,365 claims · 0.6%

Your Cost: $103.52/claim|Median: $91.47
1.1× median
93325Normal range

$335K

13K claims · 0.6%

Your Cost: $26.00/claim|Median: $14.61
1.8× median
99188Normal range

$325K

17K claims · 0.6%

Your Cost: $18.83/claim|Median: $12.80
1.5× median
99215Normal range

Office/outpatient visit, high complexity

$314K

4,761 claims · 0.5%

Your Cost: $66.01/claim|Median: $74.09
0.9× median
99395Normal range

Preventive medicine, established patient, age 18-39

$275K

5,094 claims · 0.5%

Your Cost: $54.06/claim|Median: $72.71
0.7× median
87634Normal range

$251K

5,085 claims · 0.4%

Your Cost: $49.35/claim|Median: $48.78
1.0× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$245K

9,422 claims · 0.4%

Your Cost: $26.04/claim|Median: $23.99
1.1× median
90474Normal range

$226K

28K claims · 0.4%

Your Cost: $8.04/claim|Median: $8.42
1.0× median
96110Normal range

Developmental screening, per standardized instrument

$219K

64K claims · 0.4%

Your Cost: $3.44/claim|Median: $9.10
0.4× median
99396Normal range

Preventive medicine, established patient, age 40-64

$216K

3,615 claims · 0.4%

Your Cost: $59.80/claim|Median: $76.06
0.8× median
99173Normal range

$194K

119K claims · 0.3%

Your Cost: $1.64/claim|Median: $2.16
0.8× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$171K

5,036 claims · 0.3%

Your Cost: $33.87/claim|Median: $43.85
0.8× median
96160Top 25%

Patient-focused health risk assessment

$166K

21K claims · 0.3%

Your Cost: $7.75/claim|Median: $2.10
3.7× median
87804Top 25%

Influenza virus detection, rapid test

$163K

7,348 claims · 0.3%

Your Cost: $22.17/claim|Median: $12.59
1.8× median
99462Normal range

$159K

6,763 claims · 0.3%

Your Cost: $23.47/claim|Median: $27.49
0.9× median
T1015Normal range

Clinic visit/encounter, all-inclusive

$157K

6,309 claims · 0.3%

Your Cost: $24.88/claim|Median: $121.16
0.2× median
93000Normal range

Electrocardiogram, complete, with interpretation and report

$143K

11K claims · 0.2%

Your Cost: $13.31/claim|Median: $9.70
1.4× median
93306Top 25%

Echocardiography, transthoracic, complete, with Doppler

$140K

830 claims · 0.2%

Your Cost: $169.05/claim|Median: $54.68
3.1× median
99385Normal range

Preventive visit, new patient, 18-39 yr

$124K

2,125 claims · 0.2%

Your Cost: $58.18/claim|Median: $76.22
0.8× median
99220Normal range

$119K

1,531 claims · 0.2%

Your Cost: $77.91/claim|Median: $73.56
1.1× median
97802Normal range

Medical nutrition therapy, reassessment, individual, fifteen minutes

$110K

105K claims · 0.2%

Your Cost: $1.05/claim|Median: $12.70
0.1× median
98960Normal range

$95K

35K claims · 0.2%

Your Cost: $2.76/claim|Median: $12.74
0.2× median
87811Normal range

SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-read

$95K

3,509 claims · 0.2%

Your Cost: $27.01/claim|Median: $30.53
0.9× median
85025Normal range

Complete blood count (CBC) with differential, automated

$87K

18K claims · 0.2%

Your Cost: $4.85/claim|Median: $4.71
1.0× median
83655Normal range

$86K

9,312 claims · 0.2%

Your Cost: $9.28/claim|Median: $10.49
0.9× median

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