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

⚖️ Compare🖨️ Print Report

Provider 1265836043

NPI: 1265836043Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$8.8M

$8,757,112

Total Claims

183K

Beneficiaries

154K

1.2 claims/patient

Avg Cost/Claim

$48

Monthly Spending Trend

Yearly Spending

2018
$1.1M
+19%
2019
$1.3M
-31%
2020
$864K
+30%
2021
$1.1M
-9%
2022
$1.0M
+79%
2023
$1.8M
-12%
2024
$1.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 20 distinct procedure codes. The top code (V2410) accounts for 28% of total spending.

V2410Top 25%

$2.5M

17K claims · 28.5%

Your Cost: $142.87/claim|Median: $86.18
1.7× median
92014Top 10%

Ophthalmological exam, comprehensive, established patient

$1.7M

17K claims · 19.5%

Your Cost: $100.77/claim|Median: $47.08
2.1× median
V2020Top 25%

Frames, purchases

$1.1M

28K claims · 12.8%

Your Cost: $40.30/claim|Median: $19.33
2.1× median
92004Top 10%

Ophthalmological exam, comprehensive, new patient

$740K

6,176 claims · 8.4%

Your Cost: $119.80/claim|Median: $59.72
2.0× median
V2784Top 25%

Lens, polycarbonate or equal

$704K

26K claims · 8.0%

Your Cost: $27.54/claim|Median: $9.50
2.9× median
V2103Top 10%

Lens, sphere-cylinder, single vision, plus or minus 4.00

$647K

15K claims · 7.4%

Your Cost: $41.92/claim|Median: $18.82
2.2× median
92340Normal range

Fitting of spectacles, except for aphakia

$489K

27K claims · 5.6%

Your Cost: $18.07/claim|Median: $19.46
0.9× median
V2750Top 25%

$256K

9,089 claims · 2.9%

Your Cost: $28.13/claim|Median: $10.42
2.7× median
V2104Top 10%

$249K

5,179 claims · 2.8%

Your Cost: $48.06/claim|Median: $16.70
2.9× median
V2100Top 25%

Lens, sphere, single vision, plus or minus 4.00

$220K

5,508 claims · 2.5%

Your Cost: $39.89/claim|Median: $20.68
1.9× median
99213Top 25%

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

$28K

424 claims · 0.3%

Your Cost: $66.09/claim|Median: $37.81
1.7× median
V2105Top 25%

$26K

515 claims · 0.3%

Your Cost: $50.92/claim|Median: $23.98
2.1× median
99212Top 25%

Office/outpatient visit, low complexity

$19K

476 claims · 0.2%

Your Cost: $39.72/claim|Median: $25.06
1.6× median
92015Normal range

Determination of refractive state

$17K

24K claims · 0.2%

Your Cost: $0.72/claim|Median: $10.36
0.1× median
92012Top 10%

Ophthalmological exam, intermediate, established patient

$13K

187 claims · 0.2%

Your Cost: $71.81/claim|Median: $38.23
1.9× median
99211Normal range

Office/outpatient visit, minimal complexity

$11K

658 claims · 0.1%

Your Cost: $17.23/claim|Median: $12.93
1.3× median
V2118Normal range

$11K

185 claims · 0.1%

Your Cost: $58.14/claim|Median: $60.58
1.0× median
V2107Top 25%

$9K

217 claims · 0.1%

Your Cost: $42.42/claim|Median: $17.55
2.4× median
V2108Top 5%

$2K

40 claims · 0.0%

Your Cost: $56.98/claim|Median: $16.84
3.4× median
V2744Normal range

$610

37 claims · 0.0%

Your Cost: $16.48/claim|Median: $10.12
1.6× median
← All providersHow we detect fraud →