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Provider 1396274841

NPI: 1396274841Share
Active Billing Period:2018-03→2024-12(82 months)

Total Paid

$16.1M

$16,050,245

Total Claims

384K

Beneficiaries

336K

1.1 claims/patient

Avg Cost/Claim

$42

Monthly Spending Trend

Yearly Spending

2018
$750K
+128%
2019
$1.7M
-31%
2020
$1.2M
+78%
2021
$2.1M
+56%
2022
$3.3M
+12%
2023
$3.7M
-12%
2024
$3.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99284 (Emergency dept visit, high complexity)) accounts for 24% of total spending.

99284Normal range

Emergency dept visit, high complexity

$3.9M

63K claims · 24.1%

Your Cost: $61.75/claim|Median: $69.51
0.9× median
99283Normal range

Emergency dept visit, moderate complexity

$2.7M

64K claims · 17.0%

Your Cost: $42.40/claim|Median: $42.48
1.0× median
T1015Normal range

Clinic visit/encounter, all-inclusive

$2.7M

108K claims · 16.5%

Your Cost: $24.44/claim|Median: $121.16
0.2× median
99285Normal range

Emergency dept visit, high/urgent complexity

$1.3M

18K claims · 7.8%

Your Cost: $71.47/claim|Median: $85.65
0.8× median
99213Normal range

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

$806K

27K claims · 5.0%

Your Cost: $29.57/claim|Median: $37.81
0.8× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$678K

14K claims · 4.2%

Your Cost: $47.76/claim|Median: $69.35
0.7× median
99392Normal range

Preventive medicine, established patient, age 1-4

$655K

13K claims · 4.1%

Your Cost: $48.92/claim|Median: $75.18
0.7× median
99244Normal range

Office or other outpatient consultation, moderate complexity

$507K

4,734 claims · 3.2%

Your Cost: $107.13/claim|Median: $121.58
0.9× median
99393Normal range

Preventive medicine, established patient, age 5-11

$374K

7,177 claims · 2.3%

Your Cost: $52.10/claim|Median: $74.82
0.7× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$263K

6,977 claims · 1.6%

Your Cost: $37.67/claim|Median: $37.22
1.0× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$245K

7,242 claims · 1.5%

Your Cost: $33.85/claim|Median: $23.99
1.4× median
99223Normal range

Initial hospital care, per day, high complexity

$245K

2,467 claims · 1.5%

Your Cost: $99.25/claim|Median: $67.32
1.5× median
54161Normal range

$228K

1,521 claims · 1.4%

Your Cost: $150.02/claim|Median: $252.63
0.6× median
99214Normal range

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

$198K

3,621 claims · 1.2%

Your Cost: $54.66/claim|Median: $53.41
1.0× median
99233Normal range

Subsequent hospital care, per day, high complexity

$187K

3,676 claims · 1.2%

Your Cost: $50.97/claim|Median: $35.30
1.4× median
99243Normal range

Office or other outpatient consultation, low complexity

$160K

2,102 claims · 1.0%

Your Cost: $76.21/claim|Median: $82.43
0.9× median
99222Normal range

Initial hospital care, per day, moderate complexity

$156K

2,495 claims · 1.0%

Your Cost: $62.58/claim|Median: $51.25
1.2× median
99394Normal range

Preventive medicine, established patient, age 12-17

$144K

2,774 claims · 0.9%

Your Cost: $52.03/claim|Median: $80.15
0.6× median
0241UNormal range

Proprietary lab analysis, genomic sequencing

$124K

1,644 claims · 0.8%

Your Cost: $75.14/claim|Median: $91.47
0.8× median
87631Top 25%

Respiratory virus detection, 3-5 targets, multiplex

$79K

672 claims · 0.5%

Your Cost: $117.54/claim|Median: $65.45
1.8× median
87651Top 25%

Streptococcus Group A detection, nucleic acid, amplified probe

$64K

1,672 claims · 0.4%

Your Cost: $38.06/claim|Median: $28.46
1.3× median
99381Normal range

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

$40K

989 claims · 0.3%

Your Cost: $40.59/claim|Median: $73.46
0.6× median
90670Normal range

$36K

3,126 claims · 0.2%

Your Cost: $11.52/claim|Median: $5.94
1.9× median
90647Top 25%

$31K

2,379 claims · 0.2%

Your Cost: $13.09/claim|Median: $4.31
3.0× median
90697Normal range

$27K

2,004 claims · 0.2%

Your Cost: $13.60/claim|Median: $7.24
1.9× median
90633Top 25%

$27K

2,393 claims · 0.2%

Your Cost: $11.16/claim|Median: $3.56
3.1× median
90723Normal range

DTaP-HepB-IPV vaccine

$25K

2,155 claims · 0.2%

Your Cost: $11.67/claim|Median: $5.78
2.0× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$23K

1,819 claims · 0.1%

Your Cost: $12.74/claim|Median: $7.18
1.8× median
90681Top 25%

$22K

1,906 claims · 0.1%

Your Cost: $11.62/claim|Median: $5.74
2.0× median
54640Normal range

$17K

44 claims · 0.1%

Your Cost: $395.36/claim|Median: $886.80
0.4× median
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