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Provider 1265549919

NPI: 1265549919Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$17.5M

$17,532,760

Total Claims

443K

Beneficiaries

282K

1.6 claims/patient

Avg Cost/Claim

$40

Monthly Spending Trend

Yearly Spending

2018
$1.3M
+10%
2019
$1.4M
+13%
2020
$1.6M
+18%
2021
$1.9M
+100%
2022
$3.9M
+3%
2023
$4.0M
-17%
2024
$3.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 48% of total spending.

T1015Top 25%

Clinic visit/encounter, all-inclusive

$8.5M

48K claims · 48.2%

Your Cost: $175.28/claim|Median: $121.16
1.4× median
99214Normal range

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

$2.1M

47K claims · 12.2%

Your Cost: $45.46/claim|Median: $53.41
0.9× median
99213Normal range

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

$1.6M

50K claims · 9.3%

Your Cost: $32.70/claim|Median: $37.81
0.9× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$1.0M

22K claims · 5.9%

Your Cost: $47.80/claim|Median: $58.55
0.8× median
76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$703K

7,386 claims · 4.0%

Your Cost: $95.14/claim|Median: $106.79
0.9× median
99199Normal range

Unlisted special service, procedure, or report

$651K

126K claims · 3.7%

Your Cost: $5.18/claim|Median: $5.39
1.0× median
76805Normal range

Ultrasound, pregnant uterus, complete, single fetus

$475K

7,730 claims · 2.7%

Your Cost: $61.40/claim|Median: $74.78
0.8× median
59025Normal range

Fetal non-stress test

$471K

27K claims · 2.7%

Your Cost: $17.40/claim|Median: $26.45
0.7× median
76818Normal range

$330K

6,147 claims · 1.9%

Your Cost: $53.67/claim|Median: $68.15
0.8× median
76817Normal range

Ultrasound, pregnant uterus, transvaginal

$223K

4,496 claims · 1.3%

Your Cost: $49.62/claim|Median: $47.65
1.0× median
59409Normal range

Vaginal delivery only

$217K

369 claims · 1.2%

Your Cost: $589.11/claim|Median: $619.91
1.0× median
59410Normal range

$213K

352 claims · 1.2%

Your Cost: $605.16/claim|Median: $781.64
0.8× median
99238Top 25%

Hospital discharge day management, 30 minutes or less

$103K

1,987 claims · 0.6%

Your Cost: $51.73/claim|Median: $37.22
1.4× median
76819Normal range

Fetal biophysical profile with non-stress test

$97K

2,656 claims · 0.6%

Your Cost: $36.70/claim|Median: $49.45
0.7× median
76820Normal range

$95K

3,756 claims · 0.5%

Your Cost: $25.36/claim|Median: $31.79
0.8× median
99232Top 10%

Subsequent hospital care, per day, moderate complexity

$95K

1,854 claims · 0.5%

Your Cost: $51.31/claim|Median: $23.99
2.1× median
76830Normal range

Ultrasound, transvaginal

$73K

1,615 claims · 0.4%

Your Cost: $45.33/claim|Median: $57.47
0.8× median
80305Normal range

$57K

6,850 claims · 0.3%

Your Cost: $8.29/claim|Median: $7.44
1.1× median
99243Normal range

Office or other outpatient consultation, low complexity

$51K

654 claims · 0.3%

Your Cost: $78.65/claim|Median: $82.43
1.0× median
76801Normal range

Ultrasound, pregnant uterus, single fetus, first trimester

$49K

621 claims · 0.3%

Your Cost: $78.69/claim|Median: $58.16
1.4× median
99282Normal range

Emergency dept visit, low complexity

$39K

1,402 claims · 0.2%

Your Cost: $28.04/claim|Median: $37.72
0.7× median
S0281Normal range

$38K

535 claims · 0.2%

Your Cost: $70.21/claim|Median: $92.97
0.8× median
S0280Normal range

Medical home program, comprehensive care management

$35K

1,466 claims · 0.2%

Your Cost: $24.05/claim|Median: $48.38
0.5× median
36415Normal range

Collection of venous blood by venipuncture

$34K

21K claims · 0.2%

Your Cost: $1.61/claim|Median: $1.57
1.0× median
81003Normal range

Urinalysis, automated without microscopy

$29K

16K claims · 0.2%

Your Cost: $1.75/claim|Median: $1.48
1.2× median
81025Normal range

Urine pregnancy test

$28K

6,345 claims · 0.2%

Your Cost: $4.48/claim|Median: $4.81
0.9× median
99231Top 25%

Subsequent hospital care, per day, low complexity

$28K

1,031 claims · 0.2%

Your Cost: $27.25/claim|Median: $16.77
1.6× median
99241Normal range

Office consultation, straightforward

$21K

678 claims · 0.1%

Your Cost: $30.90/claim|Median: $36.49
0.8× median
99212Normal range

Office/outpatient visit, low complexity

$13K

2,208 claims · 0.1%

Your Cost: $5.93/claim|Median: $25.06
0.2× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$11K

4,791 claims · 0.1%

Your Cost: $2.40/claim|Median: $3.67
0.7× median
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