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Provider 1295840007

NPI: 1295840007Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$13.7M

$13,738,458

Total Claims

325K

Beneficiaries

271K

1.2 claims/patient

Avg Cost/Claim

$42

Monthly Spending Trend

Yearly Spending

2018
$1.2M
-9%
2019
$1.1M
+15%
2020
$1.2M
+18%
2021
$1.4M
+21%
2022
$1.7M
+97%
2023
$3.4M
+9%
2024
$3.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 17% of total spending.

99214Top 10%

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

$2.4M

23K claims · 17.3%

Your Cost: $103.82/claim|Median: $53.41
1.9× median
99213Top 5%

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

$1.6M

17K claims · 12.0%

Your Cost: $98.27/claim|Median: $37.81
2.6× median
99212Top 5%

Office/outpatient visit, low complexity

$1.6M

15K claims · 11.5%

Your Cost: $105.04/claim|Median: $25.06
4.2× median
99285Normal range

Emergency dept visit, high/urgent complexity

$1.2M

10K claims · 8.7%

Your Cost: $113.95/claim|Median: $85.65
1.3× median
99284Top 25%

Emergency dept visit, high complexity

$916K

7,142 claims · 6.7%

Your Cost: $128.23/claim|Median: $69.51
1.8× median
99283Top 25%

Emergency dept visit, moderate complexity

$783K

6,166 claims · 5.7%

Your Cost: $126.94/claim|Median: $42.48
3.0× median
99215Top 25%

Office/outpatient visit, high complexity

$495K

3,506 claims · 3.6%

Your Cost: $141.08/claim|Median: $74.09
1.9× median
97110Top 5%

Therapeutic exercises, each 15 min

$449K

5,384 claims · 3.3%

Your Cost: $83.31/claim|Median: $24.49
3.4× median
99282Top 25%

Emergency dept visit, low complexity

$444K

3,683 claims · 3.2%

Your Cost: $120.46/claim|Median: $37.72
3.2× median
70450Top 10%

CT head/brain without contrast

$332K

1,354 claims · 2.4%

Your Cost: $245.13/claim|Median: $45.53
5.4× median
64635Normal range

$273K

840 claims · 2.0%

Your Cost: $325.04/claim|Median: $207.78
1.6× median
92507Top 10%

Speech/hearing/language treatment

$251K

2,641 claims · 1.8%

Your Cost: $95.20/claim|Median: $49.45
1.9× median
74177Top 10%

CT abdomen and pelvis with contrast

$241K

715 claims · 1.8%

Your Cost: $336.63/claim|Median: $65.76
5.1× median
64493Top 25%

$234K

647 claims · 1.7%

Your Cost: $361.07/claim|Median: $103.44
3.5× median
76000Top 25%

$227K

2,885 claims · 1.6%

Your Cost: $78.54/claim|Median: $17.70
4.4× median
74176Top 10%

CT abdomen and pelvis without contrast

$221K

727 claims · 1.6%

Your Cost: $303.80/claim|Median: $60.19
5.0× median
99281Top 25%

Emergency dept visit, minimal complexity

$211K

1,677 claims · 1.5%

Your Cost: $125.74/claim|Median: $52.03
2.4× median
96365Top 25%

IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour

$195K

1,380 claims · 1.4%

Your Cost: $141.62/claim|Median: $54.77
2.6× median
96366Top 5%

IV infusion, therapeutic/prophylactic/diagnostic, each additional hour

$177K

566 claims · 1.3%

Your Cost: $313.02/claim|Median: $40.12
7.8× median
99211Top 5%

Office/outpatient visit, minimal complexity

$154K

1,516 claims · 1.1%

Your Cost: $101.34/claim|Median: $12.93
7.8× median
80053Normal range

Comprehensive metabolic panel

$116K

13K claims · 0.8%

Your Cost: $9.04/claim|Median: $7.24
1.2× median
0241UNormal range

Proprietary lab analysis, genomic sequencing

$103K

858 claims · 0.7%

Your Cost: $120.02/claim|Median: $91.47
1.3× median
94640Top 5%

Pressurized or nonpressurized inhalation treatment

$92K

857 claims · 0.7%

Your Cost: $107.46/claim|Median: $10.88
9.9× median
20610Top 10%

Arthrocentesis, aspiration/injection, major joint

$62K

512 claims · 0.5%

Your Cost: $121.69/claim|Median: $29.03
4.2× median
80307Normal range

Drug test, presumptive, by chemistry analyzers

$51K

2,573 claims · 0.4%

Your Cost: $20.01/claim|Median: $35.43
0.6× median
99204Normal range

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

$51K

596 claims · 0.4%

Your Cost: $84.83/claim|Median: $84.03
1.0× median
80048Normal range

Basic metabolic panel

$46K

7,585 claims · 0.3%

Your Cost: $6.09/claim|Median: $5.78
1.1× median
G0480Normal range

Drug test, definitive, 1-7 drug classes

$41K

2,658 claims · 0.3%

Your Cost: $15.53/claim|Median: $37.56
0.4× median
71046Top 25%

Chest X-ray, 2 views

$40K

1,389 claims · 0.3%

Your Cost: $29.15/claim|Median: $8.92
3.3× median
85025Normal range

Complete blood count (CBC) with differential, automated

$39K

19K claims · 0.3%

Your Cost: $2.10/claim|Median: $4.71
0.4× median
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