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

⚖️ Compare🖨️ Print Report

Provider 1265711089

NPI: 1265711089Share
Active Billing Period:2018-01→2021-08(44 months)
Billing appears to have stoppedLast active: 2021-08

Total Paid

$16.0M

$15,954,465

Total Claims

291K

Beneficiaries

277K

1.1 claims/patient

Avg Cost/Claim

$55

Monthly Spending Trend

Yearly Spending

2018
$4.7M
+5%
2019
$4.9M
-24%
2020
$3.7M
-31%
2021
$2.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99285 (Emergency dept visit, high/urgent complexity)) accounts for 42% of total spending.

99285Normal range

Emergency dept visit, high/urgent complexity

$6.7M

76K claims · 42.2%

Your Cost: $88.36/claim|Median: $85.65
1.0× median
99284Normal range

Emergency dept visit, high complexity

$4.8M

80K claims · 30.3%

Your Cost: $60.67/claim|Median: $69.51
0.9× median
99283Normal range

Emergency dept visit, moderate complexity

$2.6M

64K claims · 16.2%

Your Cost: $40.54/claim|Median: $42.48
1.0× median
99291Normal range

Critical care, first 30-74 minutes

$893K

8,882 claims · 5.6%

Your Cost: $100.52/claim|Median: $101.24
1.0× median
93010Top 5%

Electrocardiogram, interpretation and report only

$437K

37K claims · 2.7%

Your Cost: $11.77/claim|Median: $5.60
2.1× median
12001Normal range

$95K

1,179 claims · 0.6%

Your Cost: $80.30/claim|Median: $64.99
1.2× median
12002Normal range

$50K

584 claims · 0.3%

Your Cost: $85.37/claim|Median: $68.89
1.2× median
99282Normal range

Emergency dept visit, low complexity

$48K

2,104 claims · 0.3%

Your Cost: $22.66/claim|Median: $37.72
0.6× median
12011Normal range

$47K

554 claims · 0.3%

Your Cost: $85.04/claim|Median: $67.02
1.3× median
71045Normal range

Chest X-ray, single view

$40K

6,831 claims · 0.3%

Your Cost: $5.93/claim|Median: $4.93
1.2× median
99406Normal range

$39K

4,384 claims · 0.2%

Your Cost: $8.92/claim|Median: $6.53
1.4× median
93042Top 10%

$32K

4,124 claims · 0.2%

Your Cost: $7.82/claim|Median: $2.53
3.1× median
29125Normal range

$30K

497 claims · 0.2%

Your Cost: $59.36/claim|Median: $28.04
2.1× median
31500Normal range

$22K

523 claims · 0.1%

Your Cost: $41.43/claim|Median: $62.71
0.7× median
99292Normal range

$21K

438 claims · 0.1%

Your Cost: $47.95/claim|Median: $57.64
0.8× median
29515Normal range

$12K

176 claims · 0.1%

Your Cost: $65.99/claim|Median: $33.24
2.0× median
99281Normal range

Emergency dept visit, minimal complexity

$11K

749 claims · 0.1%

Your Cost: $14.66/claim|Median: $52.03
0.3× median
10061Normal range

$10K

148 claims · 0.1%

Your Cost: $65.92/claim|Median: $101.03
0.7× median
71046Normal range

Chest X-ray, 2 views

$6K

759 claims · 0.0%

Your Cost: $7.64/claim|Median: $8.92
0.9× median
99212Normal range

Office/outpatient visit, low complexity

$6K

399 claims · 0.0%

Your Cost: $14.19/claim|Median: $25.06
0.6× median
92950Normal range

$4K

52 claims · 0.0%

Your Cost: $77.08/claim|Median: $101.60
0.8× median
99213Normal range

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

$2K

129 claims · 0.0%

Your Cost: $18.95/claim|Median: $37.81
0.5× median
73120Normal range

$1K

217 claims · 0.0%

Your Cost: $6.08/claim|Median: $10.48
0.6× median
12013Normal range

$1K

12 claims · 0.0%

Your Cost: $84.38/claim|Median: $63.36
1.3× median
73620Normal range

$984

178 claims · 0.0%

Your Cost: $5.53/claim|Median: $11.93
0.5× median
36556Top 25%

$897

14 claims · 0.0%

Your Cost: $64.06/claim|Median: $43.51
1.5× median
73560Normal range

$882

147 claims · 0.0%

Your Cost: $6.00/claim|Median: $10.28
0.6× median
74018Normal range

$880

120 claims · 0.0%

Your Cost: $7.34/claim|Median: $7.00
1.0× median
72100Normal range

$861

99 claims · 0.0%

Your Cost: $8.69/claim|Median: $15.14
0.6× median
73600Normal range

$556

105 claims · 0.0%

Your Cost: $5.30/claim|Median: $9.97
0.5× median
← All providersHow we detect fraud →