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Provider 1285853135

NPI: 1285853135Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$12.8M

$12,761,407

Total Claims

358K

Beneficiaries

311K

1.2 claims/patient

Avg Cost/Claim

$36

Monthly Spending Trend

Yearly Spending

2018
$47K
+30%
2019
$61K
+3066%
2020
$1.9M
+29%
2021
$2.5M
+19%
2022
$3.0M
+5%
2023
$3.1M
-31%
2024
$2.1M

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 29% of total spending.

99213Top 10%

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

$3.7M

45K claims · 29.0%

Your Cost: $82.39/claim|Median: $37.81
2.2× median
99392Top 25%

Preventive medicine, established patient, age 1-4

$1.3M

13K claims · 10.5%

Your Cost: $100.51/claim|Median: $75.18
1.3× median
99391Top 25%

Preventive medicine, established patient, infant (under 1)

$1.2M

13K claims · 9.5%

Your Cost: $90.87/claim|Median: $69.35
1.3× median
99214Top 10%

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

$1.0M

9,237 claims · 8.1%

Your Cost: $111.92/claim|Median: $53.41
2.1× median
99393Top 25%

Preventive medicine, established patient, age 5-11

$960K

9,171 claims · 7.5%

Your Cost: $104.63/claim|Median: $74.82
1.4× median
99394Top 10%

Preventive medicine, established patient, age 12-17

$618K

5,378 claims · 4.8%

Your Cost: $114.86/claim|Median: $80.15
1.4× median
90686Top 5%

Influenza virus vaccine, quadrivalent, preservative-free, IM

$323K

15K claims · 2.5%

Your Cost: $21.44/claim|Median: $7.18
3.0× median
99212Top 25%

Office/outpatient visit, low complexity

$312K

7,016 claims · 2.4%

Your Cost: $44.40/claim|Median: $25.06
1.8× median
D1206Top 25%

Topical application of fluoride varnish

$297K

12K claims · 2.3%

Your Cost: $24.56/claim|Median: $18.12
1.4× median
96110Normal range

Developmental screening, per standardized instrument

$263K

28K claims · 2.1%

Your Cost: $9.51/claim|Median: $9.10
1.0× median
90698Top 25%

$190K

9,164 claims · 1.5%

Your Cost: $20.70/claim|Median: $6.32
3.3× median
92551Normal range

Screening audiometry, pure tone, air only

$166K

18K claims · 1.3%

Your Cost: $9.19/claim|Median: $6.61
1.4× median
90670Top 25%

$159K

7,566 claims · 1.2%

Your Cost: $21.07/claim|Median: $5.94
3.5× median
99381Normal range

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

$145K

1,619 claims · 1.1%

Your Cost: $89.64/claim|Median: $73.46
1.2× median
90680Top 10%

$123K

5,939 claims · 1.0%

Your Cost: $20.66/claim|Median: $5.58
3.7× median
99211Top 25%

Office/outpatient visit, minimal complexity

$117K

5,790 claims · 0.9%

Your Cost: $20.15/claim|Median: $12.93
1.6× median
90633Top 5%

$105K

5,023 claims · 0.8%

Your Cost: $20.98/claim|Median: $3.56
5.9× median
99395Top 25%

Preventive medicine, established patient, age 18-39

$103K

937 claims · 0.8%

Your Cost: $110.38/claim|Median: $72.71
1.5× median
87426Top 25%

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

$101K

2,624 claims · 0.8%

Your Cost: $38.45/claim|Median: $30.04
1.3× median
90744Top 5%

$97K

4,629 claims · 0.8%

Your Cost: $21.01/claim|Median: $5.00
4.2× median
92587Normal range

$86K

3,857 claims · 0.7%

Your Cost: $22.33/claim|Median: $19.24
1.2× median
90710Top 25%

MMRV vaccine

$78K

3,656 claims · 0.6%

Your Cost: $21.31/claim|Median: $7.00
3.0× median
87804Normal range

Influenza virus detection, rapid test

$77K

8,874 claims · 0.6%

Your Cost: $8.70/claim|Median: $12.59
0.7× median
G2023Normal range

Specimen collection for COVID-19 testing

$67K

4,926 claims · 0.5%

Your Cost: $13.57/claim|Median: $17.15
0.8× median
90651Normal range

HPV vaccine, 9-valent

$59K

2,725 claims · 0.5%

Your Cost: $21.65/claim|Median: $8.93
2.4× median
99173Normal range

$52K

21K claims · 0.4%

Your Cost: $2.44/claim|Median: $2.16
1.1× median
99070Normal range

$46K

7,981 claims · 0.4%

Your Cost: $5.82/claim|Median: $8.08
0.7× median
54150Normal range

$43K

813 claims · 0.3%

Your Cost: $53.48/claim|Median: $84.60
0.6× median
90677Normal range

$43K

1,491 claims · 0.3%

Your Cost: $29.15/claim|Median: $12.96
2.2× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$43K

600 claims · 0.3%

Your Cost: $72.13/claim|Median: $62.48
1.2× median
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