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

⚖️ Compare🖨️ Print Report

Provider 1265982375

NPI: 1265982375Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$7.9M

$7,877,268

Total Claims

95K

Beneficiaries

88K

1.1 claims/patient

Avg Cost/Claim

$83

Monthly Spending Trend

Yearly Spending

2018
$161K
+437%
2019
$866K
+18%
2020
$1.0M
+19%
2021
$1.2M
-13%
2022
$1.1M
+52%
2023
$1.6M
+23%
2024
$2.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (43239 (Upper GI endoscopy with biopsy)) accounts for 13% of total spending.

43239Normal range

Upper GI endoscopy with biopsy

$1.0M

5,137 claims · 12.7%

Your Cost: $194.73/claim|Median: $151.68
1.3× median
45385Normal range

Colonoscopy with polyp removal, snare technique

$932K

2,492 claims · 11.8%

Your Cost: $374.15/claim|Median: $255.17
1.5× median
99233Normal range

Subsequent hospital care, per day, high complexity

$889K

20K claims · 11.3%

Your Cost: $45.21/claim|Median: $35.30
1.3× median
45378Normal range

Colonoscopy, diagnostic

$853K

2,951 claims · 10.8%

Your Cost: $289.08/claim|Median: $225.49
1.3× median
99070Top 5%

$776K

7,572 claims · 9.8%

Your Cost: $102.44/claim|Median: $8.08
12.7× median
99152Top 10%

$616K

15K claims · 7.8%

Your Cost: $41.60/claim|Median: $7.34
5.7× median
99255Normal range

$544K

5,757 claims · 6.9%

Your Cost: $94.48/claim|Median: $90.45
1.0× median
99215Normal range

Office/outpatient visit, high complexity

$453K

6,678 claims · 5.8%

Your Cost: $67.84/claim|Median: $74.09
0.9× median
99245Normal range

Office consultation, high complexity

$415K

3,485 claims · 5.3%

Your Cost: $119.16/claim|Median: $143.30
0.8× median
45380Normal range

Colonoscopy with biopsy

$361K

1,333 claims · 4.6%

Your Cost: $270.53/claim|Median: $200.68
1.3× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$322K

3,616 claims · 4.1%

Your Cost: $88.94/claim|Median: $111.09
0.8× median
99204Normal range

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

$167K

1,588 claims · 2.1%

Your Cost: $105.01/claim|Median: $84.03
1.2× median
99214Normal range

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

$134K

2,314 claims · 1.7%

Your Cost: $57.76/claim|Median: $53.41
1.1× median
99153Normal range

$110K

9,994 claims · 1.4%

Your Cost: $11.03/claim|Median: $5.60
2.0× median
99451Top 25%

$77K

2,231 claims · 1.0%

Your Cost: $34.50/claim|Median: $20.05
1.7× median
43235Normal range

Upper GI endoscopy, diagnostic, including collection

$66K

353 claims · 0.8%

Your Cost: $186.32/claim|Median: $114.30
1.6× median
99244Normal range

Office or other outpatient consultation, moderate complexity

$48K

630 claims · 0.6%

Your Cost: $75.75/claim|Median: $121.58
0.6× median
99223Normal range

Initial hospital care, per day, high complexity

$27K

476 claims · 0.3%

Your Cost: $56.82/claim|Median: $67.32
0.8× median
00731Normal range

$17K

237 claims · 0.2%

Your Cost: $72.54/claim|Median: $64.75
1.1× median
88313Top 10%

$14K

195 claims · 0.2%

Your Cost: $72.37/claim|Median: $18.95
3.8× median
99222Normal range

Initial hospital care, per day, moderate complexity

$14K

239 claims · 0.2%

Your Cost: $58.94/claim|Median: $51.25
1.2× median
88305Top 25%

Surgical pathology, gross and microscopic examination

$11K

196 claims · 0.1%

Your Cost: $57.93/claim|Median: $35.80
1.6× median
00811Normal range

$11K

180 claims · 0.1%

Your Cost: $61.20/claim|Median: $56.15
1.1× median
G2024Top 25%

$8K

370 claims · 0.1%

Your Cost: $20.72/claim|Median: $11.59
1.8× median
99291Normal range

Critical care, first 30-74 minutes

$5K

47 claims · 0.1%

Your Cost: $114.71/claim|Median: $101.24
1.1× median
99232Top 25%

Subsequent hospital care, per day, moderate complexity

$4K

93 claims · 0.0%

Your Cost: $40.42/claim|Median: $23.99
1.7× median
00812Normal range

$3K

71 claims · 0.0%

Your Cost: $46.56/claim|Median: $59.54
0.8× median
88312Normal range

$525

16 claims · 0.0%

Your Cost: $32.79/claim|Median: $24.56
1.3× median
3017FNormal range

$0

1,239 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.12
0.0× median
1036FNormal range

$0

395 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.01
0.0× median
← All providersHow we detect fraud →