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Provider 1275602476

NPI: 1275602476Share
Active Billing Period:2018-06→2024-12(75 months)

Total Paid

$15.7M

$15,746,619

Total Claims

833K

Beneficiaries

747K

1.1 claims/patient

Avg Cost/Claim

$19

Monthly Spending Trend

Yearly Spending

2018
$22K
+12872%
2019
$2.8M
-16%
2020
$2.4M
+11%
2021
$2.6M
+6%
2022
$2.8M
+2%
2023
$2.9M
-25%
2024
$2.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 24% of total spending.

99213Normal range

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

$3.8M

127K claims · 24.4%

Your Cost: $30.24/claim|Median: $37.81
0.8× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$2.4M

29K claims · 15.1%

Your Cost: $83.47/claim|Median: $69.35
1.2× median
99392Normal range

Preventive medicine, established patient, age 1-4

$2.3M

28K claims · 14.6%

Your Cost: $82.28/claim|Median: $75.18
1.1× median
99214Normal range

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

$1.9M

50K claims · 12.0%

Your Cost: $37.79/claim|Median: $53.41
0.7× median
99393Normal range

Preventive medicine, established patient, age 5-11

$1.2M

16K claims · 7.6%

Your Cost: $74.75/claim|Median: $74.82
1.0× median
H1000Normal range

Prenatal care, at-risk assessment

$1.1M

27K claims · 7.1%

Your Cost: $40.98/claim|Median: $50.36
0.8× median
99394Normal range

Preventive medicine, established patient, age 12-17

$663K

8,620 claims · 4.2%

Your Cost: $76.94/claim|Median: $80.15
1.0× median
90471Normal range

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$307K

67K claims · 1.9%

Your Cost: $4.56/claim|Median: $9.80
0.5× median
90834Normal range

Psychotherapy, 45 minutes

$302K

5,520 claims · 1.9%

Your Cost: $54.63/claim|Median: $63.65
0.9× median
99212Normal range

Office/outpatient visit, low complexity

$267K

9,376 claims · 1.7%

Your Cost: $28.45/claim|Median: $25.06
1.1× median
90472Normal range

Immunization administration, each additional vaccine

$265K

43K claims · 1.7%

Your Cost: $6.22/claim|Median: $11.79
0.5× median
59410Normal range

$194K

212 claims · 1.2%

Your Cost: $915.33/claim|Median: $781.64
1.2× median
D0120Top 25%

Periodic oral evaluation, established patient

$108K

2,616 claims · 0.7%

Your Cost: $41.44/claim|Median: $24.34
1.7× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$92K

1,114 claims · 0.6%

Your Cost: $82.70/claim|Median: $108.91
0.8× median
90832Normal range

Psychotherapy, 30 minutes

$87K

2,193 claims · 0.6%

Your Cost: $39.56/claim|Median: $41.28
1.0× median
90791Normal range

Psychiatric diagnostic evaluation

$78K

937 claims · 0.5%

Your Cost: $83.30/claim|Median: $99.21
0.8× median
D1120Normal range

Prophylaxis, adult

$78K

2,384 claims · 0.5%

Your Cost: $32.70/claim|Median: $33.86
1.0× median
99381Normal range

Preventive visit, new patient, infant (<1 yr)

$72K

1,016 claims · 0.5%

Your Cost: $71.07/claim|Median: $73.46
1.0× median
59409Top 25%

Vaginal delivery only

$56K

67 claims · 0.4%

Your Cost: $841.38/claim|Median: $619.91
1.4× median
59430Normal range

$51K

1,364 claims · 0.3%

Your Cost: $37.08/claim|Median: $80.32
0.5× median
D1110Normal range

Prophylaxis, adult cleaning

$40K

802 claims · 0.3%

Your Cost: $49.49/claim|Median: $43.38
1.1× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$37K

620 claims · 0.2%

Your Cost: $58.97/claim|Median: $71.00
0.8× median
D0150Top 25%

Comprehensive oral evaluation, new or established patient

$29K

523 claims · 0.2%

Your Cost: $55.88/claim|Median: $32.07
1.7× median
85018Normal range

$25K

38K claims · 0.2%

Your Cost: $0.66/claim|Median: $1.71
0.4× median
59025Top 25%

Fetal non-stress test

$23K

497 claims · 0.1%

Your Cost: $46.44/claim|Median: $26.45
1.8× median
90474Normal range

$22K

7,170 claims · 0.1%

Your Cost: $3.04/claim|Median: $8.42
0.4× median
81025Normal range

Urine pregnancy test

$21K

9,626 claims · 0.1%

Your Cost: $2.23/claim|Median: $4.81
0.5× median
D2391Normal range

Resin-based composite, one surface, posterior

$18K

377 claims · 0.1%

Your Cost: $46.84/claim|Median: $54.60
0.9× median
99188Normal range

$16K

2,688 claims · 0.1%

Your Cost: $5.90/claim|Median: $12.80
0.5× median
81002Normal range

Urinalysis, non-automated without microscopy

$16K

28K claims · 0.1%

Your Cost: $0.57/claim|Median: $2.00
0.3× median
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