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Provider 1265568042

NPI: 1265568042Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$11.0M

$11,048,296

Total Claims

474K

Beneficiaries

408K

1.2 claims/patient

Avg Cost/Claim

$23

Monthly Spending Trend

Yearly Spending

2018
$106K
+38%
2019
$146K
+601%
2020
$1.0M
+107%
2021
$2.1M
+29%
2022
$2.7M
+7%
2023
$2.9M
-31%
2024
$2.0M

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 19% of total spending.

99213Normal range

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

$2.0M

57K claims · 18.5%

Your Cost: $36.03/claim|Median: $37.81
1.0× median
99214Normal range

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

$1.5M

31K claims · 14.0%

Your Cost: $49.55/claim|Median: $53.41
0.9× median
95165Normal range

Professional services for allergen immunotherapy, per injection

$1.4M

7,038 claims · 12.9%

Your Cost: $202.32/claim|Median: $144.04
1.4× median
99393Normal range

Preventive medicine, established patient, age 5-11

$655K

7,519 claims · 5.9%

Your Cost: $87.05/claim|Median: $74.82
1.2× median
99392Normal range

Preventive medicine, established patient, age 1-4

$617K

7,502 claims · 5.6%

Your Cost: $82.19/claim|Median: $75.18
1.1× median
99394Normal range

Preventive medicine, established patient, age 12-17

$606K

6,405 claims · 5.5%

Your Cost: $94.62/claim|Median: $80.15
1.2× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$497K

6,411 claims · 4.5%

Your Cost: $77.58/claim|Median: $69.35
1.1× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$382K

36K claims · 3.5%

Your Cost: $10.48/claim|Median: $17.85
0.6× median
95004Top 10%

Percutaneous allergy skin tests, each

$330K

1,053 claims · 3.0%

Your Cost: $313.65/claim|Median: $134.97
2.3× median
87635Top 25%

COVID-19 SARS-CoV-2 amplified probe detection

$305K

6,182 claims · 2.8%

Your Cost: $49.37/claim|Median: $39.70
1.2× median
87428Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay, each

$239K

6,464 claims · 2.2%

Your Cost: $36.91/claim|Median: $39.63
0.9× median
99091Top 25%

$233K

1,513 claims · 2.1%

Your Cost: $154.11/claim|Median: $22.29
6.9× median
S8301Normal range

$182K

14K claims · 1.6%

Your Cost: $13.19/claim|Median: $8.32
1.6× median
99395Normal range

Preventive medicine, established patient, age 18-39

$176K

2,529 claims · 1.6%

Your Cost: $69.45/claim|Median: $72.71
1.0× median
99203Normal range

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

$133K

2,367 claims · 1.2%

Your Cost: $56.30/claim|Median: $57.85
1.0× median
99429Top 25%

$121K

3,563 claims · 1.1%

Your Cost: $34.02/claim|Median: $28.58
1.2× median
99444Normal range

$108K

1,917 claims · 1.0%

Your Cost: $56.19/claim|Median: $56.66
1.0× median
99381Normal range

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

$97K

1,275 claims · 0.9%

Your Cost: $76.00/claim|Median: $73.46
1.0× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$83K

6,309 claims · 0.8%

Your Cost: $13.14/claim|Median: $11.48
1.1× median
99211Normal range

Office/outpatient visit, minimal complexity

$77K

8,056 claims · 0.7%

Your Cost: $9.59/claim|Median: $12.93
0.7× median
99396Normal range

Preventive medicine, established patient, age 40-64

$77K

1,253 claims · 0.7%

Your Cost: $61.47/claim|Median: $76.06
0.8× median
96110Normal range

Developmental screening, per standardized instrument

$76K

9,098 claims · 0.7%

Your Cost: $8.35/claim|Median: $9.10
0.9× median
H0049Normal range

$72K

6,202 claims · 0.7%

Your Cost: $11.63/claim|Median: $9.27
1.3× median
95923Normal range

$68K

972 claims · 0.6%

Your Cost: $69.56/claim|Median: $44.24
1.6× median
99423Top 25%

Online digital E/M, 21+ min

$64K

1,139 claims · 0.6%

Your Cost: $55.87/claim|Median: $38.12
1.5× median
87804Normal range

Influenza virus detection, rapid test

$63K

4,828 claims · 0.6%

Your Cost: $13.07/claim|Median: $12.59
1.0× median
87426Top 1%

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$63K

851 claims · 0.6%

Your Cost: $73.58/claim|Median: $30.04
2.4× median
90461Normal range

Immunization admin, additional vaccine, counseling

$59K

7,385 claims · 0.5%

Your Cost: $8.00/claim|Median: $6.93
1.2× median
99204Normal range

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

$48K

609 claims · 0.4%

Your Cost: $79.23/claim|Median: $84.03
0.9× median
95921Normal range

$47K

971 claims · 0.4%

Your Cost: $48.43/claim|Median: $31.18
1.6× median
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