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Provider 1366591794

NPI: 1366591794Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$13.8M

$13,799,565

Total Claims

693K

Beneficiaries

641K

1.1 claims/patient

Avg Cost/Claim

$20

Monthly Spending Trend

Yearly Spending

2018
$1.3M
+7%
2019
$1.4M
-10%
2020
$1.3M
+59%
2021
$2.0M
+11%
2022
$2.3M
+21%
2023
$2.7M
+1%
2024
$2.8M

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.

99213Normal range

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

$3.8M

75K claims · 27.3%

Your Cost: $50.39/claim|Median: $37.81
1.3× median
99214Normal range

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

$3.3M

46K claims · 24.2%

Your Cost: $72.68/claim|Median: $53.41
1.4× median
99203Normal range

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

$675K

11K claims · 4.9%

Your Cost: $60.94/claim|Median: $57.85
1.1× median
99204Normal range

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

$647K

6,967 claims · 4.7%

Your Cost: $92.87/claim|Median: $84.03
1.1× median
59426Top 25%

Antepartum care only, high risk, additional visits

$555K

645 claims · 4.0%

Your Cost: $859.96/claim|Median: $122.30
7.0× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$440K

6,838 claims · 3.2%

Your Cost: $64.28/claim|Median: $69.35
0.9× median
59409Normal range

Vaginal delivery only

$374K

534 claims · 2.7%

Your Cost: $700.83/claim|Median: $619.91
1.1× median
99392Normal range

Preventive medicine, established patient, age 1-4

$343K

4,454 claims · 2.5%

Your Cost: $77.02/claim|Median: $75.18
1.0× median
99212Normal range

Office/outpatient visit, low complexity

$259K

8,719 claims · 1.9%

Your Cost: $29.65/claim|Median: $25.06
1.2× median
99395Normal range

Preventive medicine, established patient, age 18-39

$242K

2,987 claims · 1.8%

Your Cost: $80.89/claim|Median: $72.71
1.1× median
99396Normal range

Preventive medicine, established patient, age 40-64

$241K

2,652 claims · 1.7%

Your Cost: $91.03/claim|Median: $76.06
1.2× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$238K

6,102 claims · 1.7%

Your Cost: $39.02/claim|Median: $39.70
1.0× median
99393Normal range

Preventive medicine, established patient, age 5-11

$188K

2,475 claims · 1.4%

Your Cost: $75.80/claim|Median: $74.82
1.0× median
87502Normal range

Influenza virus detection, reverse transcription, amplified probe

$174K

2,669 claims · 1.3%

Your Cost: $65.18/claim|Median: $65.64
1.0× median
99215Normal range

Office/outpatient visit, high complexity

$165K

1,656 claims · 1.2%

Your Cost: $99.91/claim|Median: $74.09
1.3× median
90472Top 25%

Immunization administration, each additional vaccine

$148K

7,618 claims · 1.1%

Your Cost: $19.43/claim|Median: $11.79
1.6× median
99394Normal range

Preventive medicine, established patient, age 12-17

$137K

1,692 claims · 1.0%

Your Cost: $81.23/claim|Median: $80.15
1.0× median
59430Top 10%

$131K

617 claims · 0.9%

Your Cost: $212.17/claim|Median: $80.32
2.6× median
90471Normal range

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$126K

12K claims · 0.9%

Your Cost: $10.12/claim|Median: $9.80
1.0× median
87651Normal range

Streptococcus Group A detection, nucleic acid, amplified probe

$116K

4,905 claims · 0.8%

Your Cost: $23.68/claim|Median: $28.46
0.8× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$112K

2,097 claims · 0.8%

Your Cost: $53.42/claim|Median: $62.48
0.9× median
J1050Top 25%

Injection, medroxyprogesterone acetate, one milligram

$96K

1,359 claims · 0.7%

Your Cost: $70.59/claim|Median: $41.92
1.7× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$93K

2,239 claims · 0.7%

Your Cost: $41.48/claim|Median: $37.22
1.1× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$85K

2,110 claims · 0.6%

Your Cost: $40.25/claim|Median: $40.11
1.0× median
45380Normal range

Colonoscopy with biopsy

$83K

1,207 claims · 0.6%

Your Cost: $68.37/claim|Median: $200.68
0.3× median
43239Normal range

Upper GI endoscopy with biopsy

$82K

2,127 claims · 0.6%

Your Cost: $38.44/claim|Median: $151.68
0.3× median
20610Normal range

Arthrocentesis, aspiration/injection, major joint

$72K

2,062 claims · 0.5%

Your Cost: $35.04/claim|Median: $29.03
1.2× median
45385Normal range

Colonoscopy with polyp removal, snare technique

$56K

406 claims · 0.4%

Your Cost: $138.67/claim|Median: $255.17
0.5× median
43248Normal range

$49K

718 claims · 0.4%

Your Cost: $67.92/claim|Median: $115.74
0.6× median
90715Top 25%

Tdap vaccine

$48K

2,043 claims · 0.3%

Your Cost: $23.60/claim|Median: $10.32
2.3× median
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