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Unknown Provider 1275508236

NPI: 1275508236SharePrint ReportML Risk: 82%

Total Paid

$197K

$196,906

Total Claims

3,795

Beneficiaries

2,725

1.4 claims/patient

Avg Cost/Claim

$52

🔍 Analysis

Provider Overview

is a Medicaid provider based in Unknown location. From the 2018–2024 period, this provider received $197K in Medicaid payments across 4K claims serving 3K beneficiaries.

495% growthsince first billing year

Yearly Spending

2020
$28K
+495%
2021
$169K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 36% of total spending.

99213Normal range

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

$72K

1,741 claims · 36.4%

Your Cost: $41.21/claim|Median: $37.81
1.1× median
76818Top 25%

$43K

421 claims · 21.9%

Your Cost: $102.30/claim|Median: $68.15
1.5× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$30K

412 claims · 15.0%

Your Cost: $71.77/claim|Median: $58.55
1.2× median
99212Normal range

Office/outpatient visit, low complexity

$14K

438 claims · 7.3%

Your Cost: $32.67/claim|Median: $25.06
1.3× median
76830Normal range

Ultrasound, transvaginal

$14K

189 claims · 7.1%

Your Cost: $74.48/claim|Median: $57.47
1.3× median
76856Normal range

Ultrasound, pelvic, complete

$11K

198 claims · 5.8%

Your Cost: $57.81/claim|Median: $47.58
1.2× median
76817Top 25%

Ultrasound, pregnant uterus, transvaginal

$6K

67 claims · 2.9%

Your Cost: $86.28/claim|Median: $47.65
1.8× median
76801Normal range

Ultrasound, pregnant uterus, single fetus, first trimester

$4K

45 claims · 1.9%

Your Cost: $82.22/claim|Median: $58.16
1.4× median
76805Normal range

Ultrasound, pregnant uterus, complete, single fetus

$1K

14 claims · 0.6%

Your Cost: $77.50/claim|Median: $74.78
1.0× median
99395Normal range

Preventive medicine, established patient, age 18-39

$839

42 claims · 0.4%

Your Cost: $19.97/claim|Median: $72.71
0.3× median
99203Normal range

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

$666

12 claims · 0.3%

Your Cost: $55.53/claim|Median: $57.85
1.0× median
81005Top 5%

$612

216 claims · 0.3%

Your Cost: $2.83/claim|Median: $1.10
2.6× median