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

⚖️ Compare🖨️ Print Report

Provider 1306805056

NPI: 1306805056Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$12.3M

$12,318,588

Total Claims

289K

Beneficiaries

273K

1.1 claims/patient

Avg Cost/Claim

$43

Monthly Spending Trend

Yearly Spending

2018
$1.4M
+5%
2019
$1.4M
+12%
2020
$1.6M
+23%
2021
$2.0M
+1%
2022
$2.0M
+5%
2023
$2.1M
-15%
2024
$1.8M

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 27% of total spending.

99213Top 25%

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

$3.4M

48K claims · 27.2%

Your Cost: $69.82/claim|Median: $37.81
1.8× median
99214Top 10%

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

$2.3M

23K claims · 18.8%

Your Cost: $100.08/claim|Median: $53.41
1.9× median
99393Top 25%

Preventive medicine, established patient, age 5-11

$1.0M

9,888 claims · 8.1%

Your Cost: $101.21/claim|Median: $74.82
1.4× median
90460Top 25%

Immunization administration, first vaccine/toxoid, with counseling

$988K

29K claims · 8.0%

Your Cost: $34.11/claim|Median: $17.85
1.9× median
99392Top 25%

Preventive medicine, established patient, age 1-4

$970K

9,618 claims · 7.9%

Your Cost: $100.81/claim|Median: $75.18
1.3× median
99391Top 25%

Preventive medicine, established patient, infant (under 1)

$822K

8,782 claims · 6.7%

Your Cost: $93.57/claim|Median: $69.35
1.3× median
99394Top 25%

Preventive medicine, established patient, age 12-17

$755K

6,968 claims · 6.1%

Your Cost: $108.34/claim|Median: $80.15
1.4× median
87426Top 5%

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

$375K

7,524 claims · 3.0%

Your Cost: $49.83/claim|Median: $30.04
1.7× median
99188Normal range

$328K

20K claims · 2.7%

Your Cost: $16.06/claim|Median: $12.80
1.3× median
G9153Normal range

$273K

5,255 claims · 2.2%

Your Cost: $51.97/claim|Median: $43.70
1.2× median
90461Top 25%

Immunization admin, additional vaccine, counseling

$230K

8,106 claims · 1.9%

Your Cost: $28.37/claim|Median: $6.93
4.1× median
87804Normal range

Influenza virus detection, rapid test

$186K

13K claims · 1.5%

Your Cost: $14.37/claim|Median: $12.59
1.1× median
99212Top 25%

Office/outpatient visit, low complexity

$100K

2,329 claims · 0.8%

Your Cost: $42.98/claim|Median: $25.06
1.7× median
96127Top 25%

Brief emotional/behavioral assessment, per standardized instrument

$92K

11K claims · 0.7%

Your Cost: $8.39/claim|Median: $3.67
2.3× median
96160Top 25%

Patient-focused health risk assessment

$82K

10K claims · 0.7%

Your Cost: $8.05/claim|Median: $2.10
3.8× median
96161Top 25%

$79K

10K claims · 0.6%

Your Cost: $7.79/claim|Median: $2.49
3.1× median
99070Normal range

$65K

9,819 claims · 0.5%

Your Cost: $6.63/claim|Median: $8.08
0.8× median
87880Top 25%

Streptococcus, Group A, rapid antigen detection

$54K

3,814 claims · 0.4%

Your Cost: $14.25/claim|Median: $11.48
1.2× median
96110Normal range

Developmental screening, per standardized instrument

$42K

4,615 claims · 0.3%

Your Cost: $9.18/claim|Median: $9.10
1.0× median
99211Normal range

Office/outpatient visit, minimal complexity

$37K

1,972 claims · 0.3%

Your Cost: $18.67/claim|Median: $12.93
1.4× median
92551Normal range

Screening audiometry, pure tone, air only

$25K

5,310 claims · 0.2%

Your Cost: $4.68/claim|Median: $6.61
0.7× median
85018Top 25%

$18K

7,367 claims · 0.1%

Your Cost: $2.43/claim|Median: $1.71
1.4× median
87502Top 10%

Influenza virus detection, reverse transcription, amplified probe

$15K

150 claims · 0.1%

Your Cost: $97.84/claim|Median: $65.64
1.5× median
83655Top 25%

$14K

1,134 claims · 0.1%

Your Cost: $12.59/claim|Median: $10.49
1.2× median
81002Top 10%

Urinalysis, non-automated without microscopy

$14K

4,415 claims · 0.1%

Your Cost: $3.07/claim|Median: $2.00
1.5× median
99177Normal range

$12K

2,654 claims · 0.1%

Your Cost: $4.42/claim|Median: $3.74
1.2× median
87807Top 25%

$10K

843 claims · 0.1%

Your Cost: $11.84/claim|Median: $10.06
1.2× median
G2023Top 5%

Specimen collection for COVID-19 testing

$10K

370 claims · 0.1%

Your Cost: $26.52/claim|Median: $17.15
1.5× median
80061Normal range

Lipid panel

$8K

762 claims · 0.1%

Your Cost: $11.08/claim|Median: $8.41
1.3× median
0071ANormal range

$7K

170 claims · 0.1%

Your Cost: $40.48/claim|Median: $38.71
1.0× median
← All providersHow we detect fraud →