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PLANNED PARENTHOOD OF CENTRAL AND WESTERN NEW YORK, INC

Clinic/Center, Ambulatory Family Planning Facility·ROCHESTER, NY·NPI: 1306909957Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$20.8M

$20,801,095

Total Claims

364K

Beneficiaries

336K

1.1 claims/patient

Avg Cost/Claim

$57

Monthly Spending Trend

Yearly Spending

2018
$1.3M
+95%
2019
$2.5M
+20%
2020
$3.0M
+15%
2021
$3.4M
+8%
2022
$3.7M
+6%
2023
$3.9M
-19%
2024
$3.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 17% of total spending.

99213Top 5%

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

$3.6M

36K claims · 17.1%

Your Cost: $100.22/claim|Median: $37.81
2.7× median
59840Top 25%

$2.9M

4,897 claims · 14.0%

Your Cost: $595.68/claim|Median: $190.09
3.1× median
99214Top 10%

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

$2.8M

27K claims · 13.4%

Your Cost: $103.70/claim|Median: $53.41
1.9× median
76817Top 5%

Ultrasound, pregnant uterus, transvaginal

$1.7M

17K claims · 8.3%

Your Cost: $103.98/claim|Median: $47.65
2.2× median
87491Normal range

Chlamydia detection, nucleic acid, amplified probe

$846K

28K claims · 4.1%

Your Cost: $30.27/claim|Median: $24.95
1.2× median
99202Top 10%

Office/outpatient visit, new patient, low complexity

$745K

8,637 claims · 3.6%

Your Cost: $86.24/claim|Median: $40.11
2.2× median
99212Top 5%

Office/outpatient visit, low complexity

$719K

5,719 claims · 3.5%

Your Cost: $125.70/claim|Median: $25.06
5.0× median
99204Top 10%

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

$706K

4,795 claims · 3.4%

Your Cost: $147.23/claim|Median: $84.03
1.8× median
J7307Normal range

Etonogestrel implant system, including implant and supplies

$702K

1,552 claims · 3.4%

Your Cost: $452.15/claim|Median: $786.43
0.6× median
99203Top 5%

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

$665K

4,720 claims · 3.2%

Your Cost: $140.82/claim|Median: $57.85
2.4× median
S0190Normal range

$631K

12K claims · 3.0%

Your Cost: $54.37/claim|Median: $58.42
0.9× median
J1050Normal range

Injection, medroxyprogesterone acetate, one milligram

$501K

16K claims · 2.4%

Your Cost: $31.80/claim|Median: $41.92
0.8× median
87591Normal range

Neisseria gonorrhoeae detection, nucleic acid, amplified probe

$498K

28K claims · 2.4%

Your Cost: $17.78/claim|Median: $23.39
0.8× median
11981Top 10%

$477K

1,798 claims · 2.3%

Your Cost: $265.39/claim|Median: $117.16
2.3× median
76815Top 5%

Ultrasound, pregnant uterus, limited

$401K

3,973 claims · 1.9%

Your Cost: $101.00/claim|Median: $36.79
2.7× median
11982Top 10%

$380K

1,376 claims · 1.8%

Your Cost: $276.17/claim|Median: $90.51
3.1× median
87661Normal range

Trichomonas vaginalis detection, nucleic acid, amplified probe

$368K

17K claims · 1.8%

Your Cost: $21.64/claim|Median: $21.08
1.0× median
76830Normal range

Ultrasound, transvaginal

$292K

3,807 claims · 1.4%

Your Cost: $76.67/claim|Median: $57.47
1.3× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$266K

20K claims · 1.3%

Your Cost: $13.15/claim|Median: $9.56
1.4× median
58300Top 25%

$266K

1,923 claims · 1.3%

Your Cost: $138.19/claim|Median: $74.77
1.8× median
99201Top 25%

Office/outpatient visit, new patient, straightforward

$240K

3,530 claims · 1.2%

Your Cost: $67.86/claim|Median: $27.38
2.5× median
99395Top 10%

Preventive medicine, established patient, age 18-39

$194K

1,623 claims · 0.9%

Your Cost: $119.34/claim|Median: $72.71
1.6× median
81025Normal range

Urine pregnancy test

$154K

35K claims · 0.7%

Your Cost: $4.38/claim|Median: $4.81
0.9× median
58301Top 25%

$128K

930 claims · 0.6%

Your Cost: $137.93/claim|Median: $49.65
2.8× median
86703Top 25%

$128K

8,602 claims · 0.6%

Your Cost: $14.84/claim|Median: $10.37
1.4× median
J7297Normal range

$116K

647 claims · 0.6%

Your Cost: $179.34/claim|Median: $569.39
0.3× median
J7298Normal range

$68K

247 claims · 0.3%

Your Cost: $274.80/claim|Median: $751.11
0.4× median
S0191Top 25%

$45K

13K claims · 0.2%

Your Cost: $3.60/claim|Median: $2.68
1.3× median
36415Top 10%

Collection of venous blood by venipuncture

$37K

6,263 claims · 0.2%

Your Cost: $5.94/claim|Median: $1.57
3.8× median
88141Normal range

$32K

1,582 claims · 0.2%

Your Cost: $19.94/claim|Median: $14.87
1.3× median
88142Top 25%

$29K

1,362 claims · 0.1%

Your Cost: $21.58/claim|Median: $14.75
1.5× median
87624Top 25%

HPV detection, high-risk types, nucleic acid

$29K

897 claims · 0.1%

Your Cost: $32.61/claim|Median: $25.57
1.3× median
J2788Top 25%

$25K

839 claims · 0.1%

Your Cost: $30.05/claim|Median: $26.98
1.1× median
J7300Normal range

$24K

66 claims · 0.1%

Your Cost: $362.65/claim|Median: $692.75
0.5× median
S4993Normal range

$23K

2,539 claims · 0.1%

Your Cost: $9.14/claim|Median: $46.61
0.2× median
86901Top 5%

$11K

307 claims · 0.1%

Your Cost: $36.99/claim|Median: $2.26
16.4× median
85018Normal range

$11K

13K claims · 0.1%

Your Cost: $0.85/claim|Median: $1.71
0.5× median
99051Normal range

$10K

965 claims · 0.0%

Your Cost: $10.70/claim|Median: $7.89
1.4× median
87210Normal range

$9K

8,290 claims · 0.0%

Your Cost: $1.12/claim|Median: $3.65
0.3× median
99385Top 25%

Preventive visit, new patient, 18-39 yr

$8K

65 claims · 0.0%

Your Cost: $120.27/claim|Median: $76.22
1.6× median
83986Normal range

$5K

7,877 claims · 0.0%

Your Cost: $0.66/claim|Median: $2.70
0.2× median
88175Normal range

Cytopathology, cervical or vaginal, ThinPrep

$5K

207 claims · 0.0%

Your Cost: $23.71/claim|Median: $19.06
1.2× median
76856Top 1%

Ultrasound, pelvic, complete

$5K

13 claims · 0.0%

Your Cost: $377.06/claim|Median: $47.58
7.9× median
99441Top 5%

Telephone E/M by physician, 5-10 min

$2K

13 claims · 0.0%

Your Cost: $146.06/claim|Median: $13.30
11.0× median
84403Normal range

Testosterone, total blood test

$2K

222 claims · 0.0%

Your Cost: $7.16/claim|Median: $17.03
0.4× median
84702Normal range

$1K

976 claims · 0.0%

Your Cost: $1.25/claim|Median: $8.25
0.2× median
86803Normal range

Hepatitis C antibody

$993

2,383 claims · 0.0%

Your Cost: $0.42/claim|Median: $10.17
0.0× median
86780Normal range

$896

2,779 claims · 0.0%

Your Cost: $0.32/claim|Median: $9.83
0.0× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$630

1,996 claims · 0.0%

Your Cost: $0.32/claim|Median: $3.67
0.1× median
J0696Normal range

$535

231 claims · 0.0%

Your Cost: $2.31/claim|Median: $1.34
1.7× median

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