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

⚖️ Compare🖨️ Print Report

Provider 1316341514

NPI: 1316341514Share
Active Billing Period:2018-05→2024-12(73 months)

Total Paid

$11.3M

$11,297,722

Total Claims

21K

Beneficiaries

20K

1.1 claims/patient

Avg Cost/Claim

$541

Monthly Spending Trend

Yearly Spending

2018
$226K
+912%
2019
$2.3M
-60%
2020
$907K
+19%
2021
$1.1M
+74%
2022
$1.9M
+54%
2023
$2.9M
-29%
2024
$2.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (42820 (Tonsillectomy and adenoidectomy, under age 12)) accounts for 25% of total spending.

42820Normal range

Tonsillectomy and adenoidectomy, under age 12

$2.8M

3,011 claims · 24.7%

Your Cost: $926.47/claim|Median: $331.68
2.8× median
42830Top 25%

$2.5M

2,178 claims · 22.1%

Your Cost: $1,147.76/claim|Median: $341.04
3.4× median
69436Normal range

Tympanostomy, general anesthesia

$2.4M

5,077 claims · 21.6%

Your Cost: $481.19/claim|Median: $205.50
2.3× median
43239Top 25%

Upper GI endoscopy with biopsy

$1.0M

2,850 claims · 8.9%

Your Cost: $351.92/claim|Median: $151.68
2.3× median
30930Top 25%

$864K

2,425 claims · 7.6%

Your Cost: $356.31/claim|Median: $46.83
7.6× median
30802Top 25%

$705K

3,313 claims · 6.2%

Your Cost: $212.87/claim|Median: $110.05
1.9× median
54161Normal range

$676K

979 claims · 6.0%

Your Cost: $690.30/claim|Median: $252.63
2.7× median
45380Normal range

Colonoscopy with biopsy

$131K

614 claims · 1.2%

Your Cost: $213.57/claim|Median: $200.68
1.1× median
44361Top 25%

$82K

207 claims · 0.7%

Your Cost: $394.33/claim|Median: $130.91
3.0× median
41010Top 25%

$78K

220 claims · 0.7%

Your Cost: $355.45/claim|Median: $143.34
2.5× median
42821Normal range

$15K

15 claims · 0.1%

Your Cost: $986.85/claim|Median: $613.18
1.6× median
54640Normal range

$11K

13 claims · 0.1%

Your Cost: $881.39/claim|Median: $886.80
1.0× median
← All providersHow we detect fraud →