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PROHEALTH CARE ASSOCIATES LLP

Internal Medicine·LAKE SUCCESS, NY·NPI: 1275596280Share

Compared to Internal Medicine Peers

Total spending distribution among 26 providers in this specialty

P25MedianP75P90

This provider's total spending of $69.5M is at the 50th percentile among 26 Internal Medicine providers.

Active Billing Period:2018-01→2022-11(58 months)
Billing appears to have stoppedLast active: 2022-11

Total Paid

$69.5M

$69,518,281

Total Claims

1.1M

Beneficiaries

900K

1.2 claims/patient

Avg Cost/Claim

$65

Monthly Spending Trend

Yearly Spending

2018
$8.4M
+71%
2019
$14.4M
+9%
2020
$15.7M
+32%
2021
$20.8M
-51%
2022
$10.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 22% of total spending.

99213Top 5%

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

$15.0M

166K claims · 21.6%

Your Cost: $90.31/claim|Median: $37.81
2.4× median
99214Top 5%

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

$7.5M

58K claims · 10.8%

Your Cost: $128.68/claim|Median: $53.41
2.4× median
S9083Top 1%

Global fee, urgent care centers

$6.0M

34K claims · 8.6%

Your Cost: $175.28/claim|Median: $103.99
1.7× median
76641Top 25%

Ultrasound imaging of one breast, complete

$2.5M

25K claims · 3.6%

Your Cost: $101.71/claim|Median: $49.03
2.1× median
77067Top 10%

Screening mammography, bilateral, including CAD

$2.3M

20K claims · 3.3%

Your Cost: $112.55/claim|Median: $39.33
2.9× median
99203Top 10%

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

$2.2M

21K claims · 3.2%

Your Cost: $109.03/claim|Median: $57.85
1.9× median
97110Normal range

Therapeutic exercises, each 15 min

$2.1M

61K claims · 3.1%

Your Cost: $35.27/claim|Median: $24.49
1.4× median
97112Top 25%

Therapeutic procedure, neuromuscular reeducation, per 15 minutes

$1.9M

50K claims · 2.7%

Your Cost: $38.11/claim|Median: $20.04
1.9× median
76700Top 25%

Ultrasound, abdominal, complete

$1.7M

15K claims · 2.4%

Your Cost: $110.30/claim|Median: $50.69
2.2× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$1.4M

62K claims · 2.0%

Your Cost: $22.96/claim|Median: $17.85
1.3× median
97530Normal range

Therapeutic activities, each 15 min

$1.4M

33K claims · 2.0%

Your Cost: $42.29/claim|Median: $33.11
1.3× median
97140Top 25%

Manual therapy techniques, per 15 minutes

$1.3M

46K claims · 1.9%

Your Cost: $29.38/claim|Median: $16.79
1.7× median
92014Top 5%

Ophthalmological exam, comprehensive, established patient

$1.2M

9,199 claims · 1.7%

Your Cost: $129.05/claim|Median: $47.08
2.7× median
92060Top 5%

$1.2M

16K claims · 1.7%

Your Cost: $72.17/claim|Median: $35.83
2.0× median
99204Top 5%

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

$1.0M

6,299 claims · 1.5%

Your Cost: $166.56/claim|Median: $84.03
2.0× median
72148Top 25%

MRI lumbar spine without contrast

$835K

3,563 claims · 1.2%

Your Cost: $234.29/claim|Median: $101.03
2.3× median
76856Top 25%

Ultrasound, pelvic, complete

$822K

9,792 claims · 1.2%

Your Cost: $83.97/claim|Median: $47.58
1.8× median
70551Top 25%

MRI brain without contrast

$788K

3,261 claims · 1.1%

Your Cost: $241.76/claim|Median: $85.39
2.8× median
73721Top 25%

MRI joint of lower extremity without contrast

$760K

3,310 claims · 1.1%

Your Cost: $229.49/claim|Median: $127.34
1.8× median
92004Top 1%

Ophthalmological exam, comprehensive, new patient

$666K

4,036 claims · 1.0%

Your Cost: $165.13/claim|Median: $59.72
2.8× median
99393Top 25%

Preventive medicine, established patient, age 5-11

$611K

6,286 claims · 0.9%

Your Cost: $97.24/claim|Median: $74.82
1.3× median
99392Top 25%

Preventive medicine, established patient, age 1-4

$596K

5,992 claims · 0.9%

Your Cost: $99.50/claim|Median: $75.18
1.3× median
99391Top 25%

Preventive medicine, established patient, infant (under 1)

$563K

6,035 claims · 0.8%

Your Cost: $93.22/claim|Median: $69.35
1.3× median
74183Top 25%

$542K

1,329 claims · 0.8%

Your Cost: $408.08/claim|Median: $151.91
2.7× median
77063Top 25%

Screening digital breast tomosynthesis, bilateral

$523K

12K claims · 0.8%

Your Cost: $45.06/claim|Median: $21.41
2.1× median
99212Top 10%

Office/outpatient visit, low complexity

$512K

6,305 claims · 0.7%

Your Cost: $81.28/claim|Median: $25.06
3.2× median
U0003Normal range

Infectious disease detection (COVID-19)

$494K

8,570 claims · 0.7%

Your Cost: $57.67/claim|Median: $63.08
0.9× median
76536Top 25%

$488K

5,094 claims · 0.7%

Your Cost: $95.72/claim|Median: $44.06
2.2× median
76830Top 25%

Ultrasound, transvaginal

$475K

4,799 claims · 0.7%

Your Cost: $98.95/claim|Median: $57.47
1.7× median
71046Top 25%

Chest X-ray, 2 views

$475K

17K claims · 0.7%

Your Cost: $28.01/claim|Median: $8.92
3.1× median
78815Top 10%

PET imaging for limited area

$470K

417 claims · 0.7%

Your Cost: $1,126.20/claim|Median: $325.10
3.5× median
70553Top 25%

MRI brain without contrast, then with contrast

$462K

1,214 claims · 0.7%

Your Cost: $380.23/claim|Median: $133.68
2.8× median
87426Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$454K

14K claims · 0.7%

Your Cost: $32.95/claim|Median: $30.04
1.1× median
31231Top 5%

Nasal endoscopy, diagnostic

$425K

1,878 claims · 0.6%

Your Cost: $226.11/claim|Median: $98.77
2.3× median
88305Top 10%

Surgical pathology, gross and microscopic examination

$399K

3,765 claims · 0.6%

Your Cost: $106.05/claim|Median: $35.80
3.0× median
99394Top 25%

Preventive medicine, established patient, age 12-17

$384K

3,666 claims · 0.6%

Your Cost: $104.82/claim|Median: $80.15
1.3× median
72197Top 25%

$379K

970 claims · 0.5%

Your Cost: $390.59/claim|Median: $201.67
1.9× median
99202Top 10%

Office/outpatient visit, new patient, low complexity

$372K

3,462 claims · 0.5%

Your Cost: $107.49/claim|Median: $40.11
2.7× median
78452Top 25%

Myocardial perfusion imaging, SPECT, multiple studies

$335K

881 claims · 0.5%

Your Cost: $380.32/claim|Median: $106.14
3.6× median
19083Normal range

$323K

484 claims · 0.5%

Your Cost: $667.05/claim|Median: $486.58
1.4× median
77065Top 10%

$322K

2,906 claims · 0.5%

Your Cost: $110.86/claim|Median: $35.39
3.1× median
72141Top 25%

MRI of cervical spine without contrast

$308K

1,369 claims · 0.4%

Your Cost: $225.04/claim|Median: $112.68
2.0× median
95165Normal range

Professional services for allergen immunotherapy, per injection

$299K

5,027 claims · 0.4%

Your Cost: $59.38/claim|Median: $144.04
0.4× median
92250Top 25%

Fundus photography with interpretation and report

$287K

6,600 claims · 0.4%

Your Cost: $43.55/claim|Median: $27.95
1.6× median
71250Top 10%

CT scan of chest without contrast

$248K

1,697 claims · 0.4%

Your Cost: $146.01/claim|Median: $39.11
3.7× median
99215Top 5%

Office/outpatient visit, high complexity

$216K

1,230 claims · 0.3%

Your Cost: $175.23/claim|Median: $74.09
2.4× median
73221Top 25%

MRI of upper extremity joint with contrast

$215K

893 claims · 0.3%

Your Cost: $240.57/claim|Median: $122.11
2.0× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$203K

20K claims · 0.3%

Your Cost: $9.96/claim|Median: $11.48
0.9× median
75574Top 25%

$189K

650 claims · 0.3%

Your Cost: $291.36/claim|Median: $102.06
2.9× median
76770Top 25%

Ultrasound, retroperitoneal, complete

$170K

1,811 claims · 0.2%

Your Cost: $93.71/claim|Median: $37.35
2.5× median

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