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

⚖️ Compare🖨️ Print Report

Provider 1285613836

NPI: 1285613836Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$12.5M

$12,520,006

Total Claims

30K

Beneficiaries

26K

1.2 claims/patient

Avg Cost/Claim

$413

Monthly Spending Trend

Yearly Spending

2018
$1.8M
-16%
2019
$1.5M
-7%
2020
$1.4M
+85%
2021
$2.6M
-29%
2022
$1.9M
+3%
2023
$1.9M
-27%
2024
$1.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 29 distinct procedure codes. The top code (99212 (Office/outpatient visit, low complexity)) accounts for 45% of total spending.

99212Top 1%

Office/outpatient visit, low complexity

$5.7M

11K claims · 45.2%

Your Cost: $492.76/claim|Median: $25.06
19.7× median
Q3014Top 1%

Telehealth originating site facility fee

$2.8M

5,226 claims · 22.5%

Your Cost: $537.88/claim|Median: $15.37
35.0× median
99394Top 1%

Preventive medicine, established patient, age 12-17

$728K

983 claims · 5.8%

Your Cost: $741.09/claim|Median: $80.15
9.2× median
99392Top 1%

Preventive medicine, established patient, age 1-4

$570K

909 claims · 4.6%

Your Cost: $626.89/claim|Median: $75.18
8.3× median
99393Top 1%

Preventive medicine, established patient, age 5-11

$428K

658 claims · 3.4%

Your Cost: $650.10/claim|Median: $74.82
8.7× median
99213Top 5%

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

$343K

3,648 claims · 2.7%

Your Cost: $94.00/claim|Median: $37.81
2.5× median
99391Top 1%

Preventive medicine, established patient, infant (under 1)

$304K

561 claims · 2.4%

Your Cost: $541.14/claim|Median: $69.35
7.8× median
0011ATop 1%

COVID-19 vaccine admin, Moderna, 1st dose

$236K

454 claims · 1.9%

Your Cost: $519.00/claim|Median: $25.93
20.0× median
0012ATop 1%

COVID-19 vaccine admin, Moderna, 2nd dose

$223K

432 claims · 1.8%

Your Cost: $516.60/claim|Median: $33.85
15.3× median
0001ATop 1%

COVID-19 vaccine admin, Pfizer, 1st dose

$221K

430 claims · 1.8%

Your Cost: $513.09/claim|Median: $33.72
15.2× median
0002ATop 1%

COVID-19 vaccine admin, Pfizer, 2nd dose

$198K

382 claims · 1.6%

Your Cost: $519.00/claim|Median: $36.70
14.1× median
G0463Top 25%

Hospital outpatient clinic visit

$176K

2,205 claims · 1.4%

Your Cost: $79.66/claim|Median: $26.41
3.0× median
0071ATop 1%

$153K

282 claims · 1.2%

Your Cost: $542.60/claim|Median: $38.71
14.0× median
0072ATop 1%

$153K

273 claims · 1.2%

Your Cost: $558.76/claim|Median: $39.57
14.1× median
99214Top 25%

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

$81K

822 claims · 0.6%

Your Cost: $98.90/claim|Median: $53.41
1.9× median
99211Top 5%

Office/outpatient visit, minimal complexity

$56K

623 claims · 0.4%

Your Cost: $90.29/claim|Median: $12.93
7.0× median
0064ATop 1%

$53K

102 claims · 0.4%

Your Cost: $515.49/claim|Median: $34.17
15.1× median
0054ATop 1%

$36K

56 claims · 0.3%

Your Cost: $640.00/claim|Median: $35.83
17.9× median
51900Normal range

$32K

115 claims · 0.3%

Your Cost: $277.53/claim|Median: $277.53
1.0× median
0124ATop 1%

$20K

31 claims · 0.2%

Your Cost: $640.00/claim|Median: $34.32
18.6× median
92014Top 1%

Ophthalmological exam, comprehensive, established patient

$16K

88 claims · 0.1%

Your Cost: $180.58/claim|Median: $47.08
3.8× median
0004ATop 1%

$14K

27 claims · 0.1%

Your Cost: $519.00/claim|Median: $35.62
14.6× median
0134ATop 1%

$9K

15 claims · 0.1%

Your Cost: $597.33/claim|Median: $33.54
17.8× median
87635Top 5%

COVID-19 SARS-CoV-2 amplified probe detection

$939

13 claims · 0.0%

Your Cost: $72.26/claim|Median: $39.70
1.8× median
G0008Normal range

$123

310 claims · 0.0%

Your Cost: $0.40/claim|Median: $2.54
0.2× median
90653Normal range

$74

112 claims · 0.0%

Your Cost: $0.66/claim|Median: $6.85
0.1× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$3

60 claims · 0.0%

Your Cost: $0.05/claim|Median: $7.18
0.0× median
90694Normal range

$0

18 claims · 0.0%

Your Cost: $0.00/claim|Median: $6.60
90688Normal range

$0

13 claims · 0.0%

Your Cost: $0.00/claim|Median: $9.00
← All providersHow we detect fraud →