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

⚖️ Compare🖨️ Print Report

Provider 1306156138

NPI: 1306156138Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$9.9M

$9,870,285

Total Claims

363K

Beneficiaries

314K

1.2 claims/patient

Avg Cost/Claim

$27

Monthly Spending Trend

Yearly Spending

2018
$1.2M
+5%
2019
$1.2M
-9%
2020
$1.1M
+46%
2021
$1.6M
+6%
2022
$1.7M
-4%
2023
$1.7M
-18%
2024
$1.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99204 (Office/outpatient visit, new patient, mod-high complexity)) accounts for 18% of total spending.

99204Normal range

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

$1.8M

20K claims · 17.9%

Your Cost: $89.45/claim|Median: $84.03
1.1× median
99203Normal range

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

$1.4M

26K claims · 14.1%

Your Cost: $54.40/claim|Median: $57.85
0.9× median
99214Normal range

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

$1.3M

23K claims · 13.3%

Your Cost: $57.18/claim|Median: $53.41
1.1× median
99213Normal range

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

$1.2M

32K claims · 12.1%

Your Cost: $36.98/claim|Median: $37.81
1.0× median
90791Normal range

Psychiatric diagnostic evaluation

$405K

6,519 claims · 4.1%

Your Cost: $62.11/claim|Median: $99.21
0.6× median
92004Normal range

Ophthalmological exam, comprehensive, new patient

$401K

7,477 claims · 4.1%

Your Cost: $53.57/claim|Median: $59.72
0.9× median
64642Normal range

$359K

4,066 claims · 3.6%

Your Cost: $88.29/claim|Median: $81.85
1.1× median
92014Normal range

Ophthalmological exam, comprehensive, established patient

$261K

5,615 claims · 2.6%

Your Cost: $46.52/claim|Median: $47.08
1.0× median
64643Normal range

$248K

3,188 claims · 2.5%

Your Cost: $77.86/claim|Median: $58.21
1.3× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$181K

4,338 claims · 1.8%

Your Cost: $41.69/claim|Median: $40.11
1.0× median
J0585Normal range

Injection, onabotulinumtoxinA, 1 unit

$170K

675 claims · 1.7%

Your Cost: $251.39/claim|Median: $470.36
0.5× median
90832Normal range

Psychotherapy, 30 minutes

$152K

4,859 claims · 1.5%

Your Cost: $31.38/claim|Median: $41.28
0.8× median
92012Normal range

Ophthalmological exam, intermediate, established patient

$149K

4,262 claims · 1.5%

Your Cost: $35.00/claim|Median: $38.23
0.9× median
43239Normal range

Upper GI endoscopy with biopsy

$143K

780 claims · 1.4%

Your Cost: $183.06/claim|Median: $151.68
1.2× median
99212Normal range

Office/outpatient visit, low complexity

$139K

6,255 claims · 1.4%

Your Cost: $22.17/claim|Median: $25.06
0.9× median
99215Normal range

Office/outpatient visit, high complexity

$126K

1,869 claims · 1.3%

Your Cost: $67.31/claim|Median: $74.09
0.9× median
99232Top 25%

Subsequent hospital care, per day, moderate complexity

$105K

2,545 claims · 1.1%

Your Cost: $41.34/claim|Median: $23.99
1.7× median
99233Normal range

Subsequent hospital care, per day, high complexity

$97K

1,829 claims · 1.0%

Your Cost: $52.92/claim|Median: $35.30
1.5× median
96131Normal range

Psychological testing evaluation, each additional hour

$87K

1,680 claims · 0.9%

Your Cost: $51.84/claim|Median: $133.38
0.4× median
96132Normal range

$82K

2,766 claims · 0.8%

Your Cost: $29.64/claim|Median: $70.53
0.4× median
90834Normal range

Psychotherapy, 45 minutes

$80K

1,952 claims · 0.8%

Your Cost: $41.19/claim|Median: $63.65
0.6× median
90863Normal range

$80K

3,470 claims · 0.8%

Your Cost: $23.00/claim|Median: $29.71
0.8× median
96130Normal range

Psychological testing evaluation by professional, first hour

$79K

3,044 claims · 0.8%

Your Cost: $26.01/claim|Median: $79.21
0.3× median
17110Normal range

Destruction of benign lesions, up to fourteen

$76K

1,153 claims · 0.8%

Your Cost: $66.21/claim|Median: $59.25
1.1× median
99231Normal range

Subsequent hospital care, per day, low complexity

$72K

3,389 claims · 0.7%

Your Cost: $21.24/claim|Median: $16.77
1.3× median
92060Normal range

$66K

4,013 claims · 0.7%

Your Cost: $16.46/claim|Median: $35.83
0.5× median
93010Normal range

Electrocardiogram, interpretation and report only

$56K

9,475 claims · 0.6%

Your Cost: $5.90/claim|Median: $5.60
1.1× median
J0586Normal range

$51K

304 claims · 0.5%

Your Cost: $166.73/claim|Median: $667.48
0.2× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$48K

398 claims · 0.5%

Your Cost: $119.79/claim|Median: $111.09
1.1× median
96101Normal range

$43K

547 claims · 0.4%

Your Cost: $79.03/claim|Median: $196.08
0.4× median
← All providersHow we detect fraud →