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

⚖️ Compare🖨️ Print Report

Provider 1366591562

NPI: 1366591562Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$11.5M

$11,534,885

Total Claims

396K

Beneficiaries

350K

1.1 claims/patient

Avg Cost/Claim

$29

Monthly Spending Trend

Yearly Spending

2018
$387K
+124%
2019
$865K
+45%
2020
$1.3M
+22%
2021
$1.5M
+64%
2022
$2.5M
-3%
2023
$2.4M
+5%
2024
$2.6M

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 32% of total spending.

99213Top 25%

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

$3.7M

59K claims · 32.4%

Your Cost: $62.88/claim|Median: $37.81
1.7× median
90837Normal range

Psychotherapy, 60 minutes

$2.0M

21K claims · 17.5%

Your Cost: $95.14/claim|Median: $85.66
1.1× median
99214Top 25%

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

$922K

12K claims · 8.0%

Your Cost: $78.39/claim|Median: $53.41
1.5× median
99392Normal range

Preventive medicine, established patient, age 1-4

$604K

7,873 claims · 5.2%

Your Cost: $76.68/claim|Median: $75.18
1.0× median
59426Normal range

Antepartum care only, high risk, additional visits

$576K

964 claims · 5.0%

Your Cost: $597.02/claim|Median: $122.30
4.9× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$569K

8,067 claims · 4.9%

Your Cost: $70.50/claim|Median: $69.35
1.0× median
59430Top 5%

$263K

1,199 claims · 2.3%

Your Cost: $219.42/claim|Median: $80.32
2.7× median
99393Normal range

Preventive medicine, established patient, age 5-11

$191K

2,504 claims · 1.7%

Your Cost: $76.21/claim|Median: $74.82
1.0× median
90670Top 10%

$120K

4,987 claims · 1.0%

Your Cost: $24.06/claim|Median: $5.94
4.1× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$109K

8,728 claims · 0.9%

Your Cost: $12.45/claim|Median: $7.18
1.7× median
90677Top 25%

$100K

1,437 claims · 0.9%

Your Cost: $69.36/claim|Median: $12.96
5.4× median
99203Top 10%

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

$95K

937 claims · 0.8%

Your Cost: $101.84/claim|Median: $57.85
1.8× median
99394Normal range

Preventive medicine, established patient, age 12-17

$91K

1,097 claims · 0.8%

Your Cost: $82.83/claim|Median: $80.15
1.0× median
76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$89K

768 claims · 0.8%

Your Cost: $115.55/claim|Median: $106.79
1.1× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$83K

1,529 claims · 0.7%

Your Cost: $54.17/claim|Median: $71.00
0.8× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$81K

3,927 claims · 0.7%

Your Cost: $20.57/claim|Median: $32.07
0.6× median
3008FNormal range

$77K

97K claims · 0.7%

Your Cost: $0.80/claim|Median: $0.06
13.3× median
D1120Normal range

Prophylaxis, adult

$68K

2,710 claims · 0.6%

Your Cost: $25.03/claim|Median: $33.86
0.7× median
90834Normal range

Psychotherapy, 45 minutes

$66K

980 claims · 0.6%

Your Cost: $67.78/claim|Median: $63.65
1.1× median
99395Normal range

Preventive medicine, established patient, age 18-39

$66K

842 claims · 0.6%

Your Cost: $78.86/claim|Median: $72.71
1.1× median
92551Top 25%

Screening audiometry, pure tone, air only

$65K

6,817 claims · 0.6%

Your Cost: $9.56/claim|Median: $6.61
1.4× median
D1206Normal range

Topical application of fluoride varnish

$65K

4,047 claims · 0.6%

Your Cost: $15.99/claim|Median: $18.12
0.9× median
90697Top 10%

$62K

1,698 claims · 0.5%

Your Cost: $36.46/claim|Median: $7.24
5.0× median
99381Normal range

Preventive visit, new patient, infant (<1 yr)

$60K

829 claims · 0.5%

Your Cost: $72.39/claim|Median: $73.46
1.0× median
99396Normal range

Preventive medicine, established patient, age 40-64

$56K

671 claims · 0.5%

Your Cost: $83.76/claim|Median: $76.06
1.1× median
76816Top 25%

Ultrasound, pregnant uterus, follow-up

$55K

618 claims · 0.5%

Your Cost: $89.53/claim|Median: $58.55
1.5× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$53K

18K claims · 0.5%

Your Cost: $2.89/claim|Median: $17.85
0.2× median
87804Normal range

Influenza virus detection, rapid test

$52K

3,869 claims · 0.4%

Your Cost: $13.39/claim|Median: $12.59
1.1× median
D0120Normal range

Periodic oral evaluation, established patient

$51K

3,676 claims · 0.4%

Your Cost: $13.89/claim|Median: $24.34
0.6× median
90651Top 25%

HPV vaccine, 9-valent

$50K

1,087 claims · 0.4%

Your Cost: $45.90/claim|Median: $8.93
5.1× median
← All providersHow we detect fraud →