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

⚖️ Compare🖨️ Print Report

Provider 1265929723

NPI: 1265929723Share
Active Billing Period:2018-09→2024-12(76 months)

Total Paid

$11.9M

$11,887,307

Total Claims

662K

Beneficiaries

434K

1.5 claims/patient

Avg Cost/Claim

$18

Monthly Spending Trend

Yearly Spending

2018
$62K
+392%
2019
$303K
+332%
2020
$1.3M
+36%
2021
$1.8M
+35%
2022
$2.4M
+54%
2023
$3.7M
-36%
2024
$2.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 30% of total spending.

99214Normal range

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

$3.5M

92K claims · 29.7%

Your Cost: $38.48/claim|Median: $53.41
0.7× median
96413Normal range

Chemotherapy administration, IV infusion, up to 1 hour

$2.1M

34K claims · 17.8%

Your Cost: $61.87/claim|Median: $75.28
0.8× median
99213Normal range

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

$1.3M

46K claims · 10.9%

Your Cost: $28.21/claim|Median: $37.81
0.7× median
J9271Normal range

Injection, pembrolizumab, 1 mg

$997K

170 claims · 8.4%

Your Cost: $5,862.50/claim|Median: $5,391.55
1.1× median
85025Normal range

Complete blood count (CBC) with differential, automated

$711K

169K claims · 6.0%

Your Cost: $4.22/claim|Median: $4.71
0.9× median
99215Normal range

Office/outpatient visit, high complexity

$358K

5,305 claims · 3.0%

Your Cost: $67.57/claim|Median: $74.09
0.9× median
99232Top 25%

Subsequent hospital care, per day, moderate complexity

$268K

6,625 claims · 2.3%

Your Cost: $40.47/claim|Median: $23.99
1.7× median
96367Normal range

$244K

11K claims · 2.1%

Your Cost: $22.33/claim|Median: $29.27
0.8× median
36415Normal range

Collection of venous blood by venipuncture

$231K

139K claims · 1.9%

Your Cost: $1.67/claim|Median: $1.57
1.1× median
96365Normal range

IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour

$224K

6,290 claims · 1.9%

Your Cost: $35.64/claim|Median: $54.77
0.7× median
99223Top 25%

Initial hospital care, per day, high complexity

$217K

2,079 claims · 1.8%

Your Cost: $104.22/claim|Median: $67.32
1.5× median
J2469Normal range

Injection, palonosetron HCl, twenty-five micrograms

$136K

5,820 claims · 1.1%

Your Cost: $23.35/claim|Median: $25.23
0.9× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$124K

13K claims · 1.0%

Your Cost: $9.56/claim|Median: $9.56
1.0× median
96375Normal range

Therapeutic/prophylactic/diagnostic IV push, each additional substance

$119K

8,679 claims · 1.0%

Your Cost: $13.69/claim|Median: $14.92
0.9× median
80053Normal range

Comprehensive metabolic panel

$117K

35K claims · 1.0%

Your Cost: $3.34/claim|Median: $7.24
0.5× median
J0185Normal range

$116K

951 claims · 1.0%

Your Cost: $122.03/claim|Median: $125.72
1.0× median
99204Normal range

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

$112K

1,298 claims · 0.9%

Your Cost: $85.92/claim|Median: $84.03
1.0× median
78815Normal range

PET imaging for limited area

$84K

241 claims · 0.7%

Your Cost: $349.48/claim|Median: $325.10
1.1× median
J1437Normal range

$84K

148 claims · 0.7%

Your Cost: $565.93/claim|Median: $979.19
0.6× median
96417Normal range

$83K

2,760 claims · 0.7%

Your Cost: $30.09/claim|Median: $37.60
0.8× median
Q5126Normal range

$70K

47 claims · 0.6%

Your Cost: $1,497.50/claim|Median: $1,497.50
1.0× median
J0897Normal range

Injection, denosumab, one milligram

$67K

80 claims · 0.6%

Your Cost: $836.47/claim|Median: $493.25
1.7× median
J1453Normal range

$66K

991 claims · 0.6%

Your Cost: $66.18/claim|Median: $65.90
1.0× median
J1756Top 25%

Injection, iron sucrose, 1 mg

$63K

2,433 claims · 0.5%

Your Cost: $25.74/claim|Median: $4.58
5.6× median
Q5118Top 25%

$53K

38 claims · 0.4%

Your Cost: $1,385.49/claim|Median: $722.03
1.9× median
82728Normal range

Ferritin

$32K

8,328 claims · 0.3%

Your Cost: $3.87/claim|Median: $6.00
0.6× median
99203Normal range

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

$27K

467 claims · 0.2%

Your Cost: $58.70/claim|Median: $57.85
1.0× median
96523Normal range

$22K

1,573 claims · 0.2%

Your Cost: $14.08/claim|Median: $19.90
0.7× median
J0881Normal range

Injection, darbepoetin alfa, one microgram, non-ESRD

$22K

215 claims · 0.2%

Your Cost: $102.90/claim|Median: $109.46
0.9× median
84443Normal range

Thyroid stimulating hormone (TSH)

$20K

4,898 claims · 0.2%

Your Cost: $4.16/claim|Median: $9.87
0.4× median
← All providersHow we detect fraud →