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Provider 1295999852

NPI: 1295999852Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$13.4M

$13,355,153

Total Claims

313K

Beneficiaries

205K

1.5 claims/patient

Avg Cost/Claim

$43

Monthly Spending Trend

Yearly Spending

2018
$433K
+150%
2019
$1.1M
+54%
2020
$1.7M
+34%
2021
$2.2M
+8%
2022
$2.4M
+24%
2023
$3.0M
-16%
2024
$2.5M

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 26% of total spending.

99214Normal range

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

$3.4M

51K claims · 25.5%

Your Cost: $66.49/claim|Median: $53.41
1.2× median
99213Normal range

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

$1.9M

38K claims · 14.3%

Your Cost: $50.26/claim|Median: $37.81
1.3× median
99232Top 25%

Subsequent hospital care, per day, moderate complexity

$1.2M

32K claims · 9.3%

Your Cost: $38.80/claim|Median: $23.99
1.6× median
99233Top 25%

Subsequent hospital care, per day, high complexity

$746K

12K claims · 5.6%

Your Cost: $60.95/claim|Median: $35.30
1.7× median
97112Normal range

Therapeutic procedure, neuromuscular reeducation, per 15 minutes

$514K

20K claims · 3.9%

Your Cost: $25.65/claim|Median: $20.04
1.3× median
97110Normal range

Therapeutic exercises, each 15 min

$488K

22K claims · 3.7%

Your Cost: $21.89/claim|Median: $24.49
0.9× median
99203Normal range

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

$382K

5,556 claims · 2.9%

Your Cost: $68.71/claim|Median: $57.85
1.2× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$370K

3,017 claims · 2.8%

Your Cost: $122.50/claim|Median: $108.91
1.1× median
97530Normal range

Therapeutic activities, each 15 min

$363K

11K claims · 2.7%

Your Cost: $33.00/claim|Median: $33.11
1.0× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$362K

5,747 claims · 2.7%

Your Cost: $63.03/claim|Median: $69.35
0.9× median
99204Normal range

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

$325K

3,268 claims · 2.4%

Your Cost: $99.39/claim|Median: $84.03
1.2× median
99392Normal range

Preventive medicine, established patient, age 1-4

$306K

4,168 claims · 2.3%

Your Cost: $73.32/claim|Median: $75.18
1.0× median
97140Normal range

Manual therapy techniques, per 15 minutes

$263K

16K claims · 2.0%

Your Cost: $16.77/claim|Median: $16.79
1.0× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$208K

5,119 claims · 1.6%

Your Cost: $40.57/claim|Median: $58.55
0.7× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$185K

3,000 claims · 1.4%

Your Cost: $61.68/claim|Median: $43.85
1.4× median
99222Normal range

Initial hospital care, per day, moderate complexity

$144K

2,261 claims · 1.1%

Your Cost: $63.80/claim|Median: $51.25
1.2× median
99231Normal range

Subsequent hospital care, per day, low complexity

$136K

7,499 claims · 1.0%

Your Cost: $18.17/claim|Median: $16.77
1.1× median
76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$130K

1,763 claims · 1.0%

Your Cost: $73.65/claim|Median: $106.79
0.7× median
99393Normal range

Preventive medicine, established patient, age 5-11

$114K

1,528 claims · 0.9%

Your Cost: $74.56/claim|Median: $74.82
1.0× median
97150Normal range

Therapeutic procedure, group (2+ patients)

$113K

11K claims · 0.8%

Your Cost: $9.96/claim|Median: $12.12
0.8× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$107K

2,613 claims · 0.8%

Your Cost: $40.86/claim|Median: $37.22
1.1× median
90677Top 25%

$99K

972 claims · 0.7%

Your Cost: $101.59/claim|Median: $12.96
7.8× median
99223Top 25%

Initial hospital care, per day, high complexity

$89K

826 claims · 0.7%

Your Cost: $107.29/claim|Median: $67.32
1.6× median
76819Normal range

Fetal biophysical profile with non-stress test

$84K

2,805 claims · 0.6%

Your Cost: $30.04/claim|Median: $49.45
0.6× median
90670Top 10%

$74K

2,730 claims · 0.6%

Your Cost: $27.20/claim|Median: $5.94
4.6× median
20610Normal range

Arthrocentesis, aspiration/injection, major joint

$67K

1,649 claims · 0.5%

Your Cost: $40.87/claim|Median: $29.03
1.4× median
99215Normal range

Office/outpatient visit, high complexity

$67K

887 claims · 0.5%

Your Cost: $75.63/claim|Median: $74.09
1.0× median
97162Top 25%

PT evaluation, moderate complexity

$65K

939 claims · 0.5%

Your Cost: $69.02/claim|Median: $46.10
1.5× median
99221Normal range

Initial hospital care, straightforward/low

$63K

1,248 claims · 0.5%

Your Cost: $50.13/claim|Median: $39.96
1.3× median
97161Top 25%

Physical therapy evaluation, low complexity

$54K

772 claims · 0.4%

Your Cost: $70.38/claim|Median: $47.89
1.5× median
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