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Provider 1396970109

NPI: 1396970109Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$10.0M

$10,030,095

Total Claims

133K

Beneficiaries

104K

1.3 claims/patient

Avg Cost/Claim

$75

Monthly Spending Trend

Yearly Spending

2018
$1.7M
+14%
2019
$1.9M
-32%
2020
$1.3M
-17%
2021
$1.1M
+22%
2022
$1.3M
+2%
2023
$1.4M
-7%
2024
$1.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 20% of total spending.

99214Normal range

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

$2.0M

29K claims · 20.2%

Your Cost: $69.39/claim|Median: $53.41
1.3× median
76819Top 25%

Fetal biophysical profile with non-stress test

$1.7M

22K claims · 17.0%

Your Cost: $78.10/claim|Median: $49.45
1.6× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$1.3M

22K claims · 12.6%

Your Cost: $56.80/claim|Median: $58.55
1.0× median
76811Top 25%

Ultrasound, pregnant uterus, detailed, single fetus

$1.1M

5,876 claims · 10.7%

Your Cost: $183.10/claim|Median: $106.79
1.7× median
76820Top 10%

$944K

13K claims · 9.4%

Your Cost: $70.89/claim|Median: $31.79
2.2× median
76817Normal range

Ultrasound, pregnant uterus, transvaginal

$620K

9,161 claims · 6.2%

Your Cost: $67.67/claim|Median: $47.65
1.4× median
76821Top 25%

$428K

5,420 claims · 4.3%

Your Cost: $79.02/claim|Median: $46.75
1.7× median
99213Normal range

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

$374K

8,412 claims · 3.7%

Your Cost: $44.42/claim|Median: $37.81
1.2× median
76818Normal range

$273K

3,405 claims · 2.7%

Your Cost: $80.16/claim|Median: $68.15
1.2× median
76825Normal range

$273K

2,238 claims · 2.7%

Your Cost: $121.82/claim|Median: $103.74
1.2× median
99215Normal range

Office/outpatient visit, high complexity

$259K

2,666 claims · 2.6%

Your Cost: $97.25/claim|Median: $74.09
1.3× median
93325Top 10%

$189K

2,127 claims · 1.9%

Your Cost: $88.94/claim|Median: $14.61
6.1× median
76827Top 10%

$186K

2,258 claims · 1.9%

Your Cost: $82.25/claim|Median: $39.58
2.1× median
99244Normal range

Office or other outpatient consultation, moderate complexity

$105K

751 claims · 1.0%

Your Cost: $139.23/claim|Median: $121.58
1.1× median
76805Normal range

Ultrasound, pregnant uterus, complete, single fetus

$83K

884 claims · 0.8%

Your Cost: $93.52/claim|Median: $74.78
1.3× median
99243Normal range

Office or other outpatient consultation, low complexity

$40K

424 claims · 0.4%

Your Cost: $93.30/claim|Median: $82.43
1.1× median
76815Normal range

Ultrasound, pregnant uterus, limited

$38K

634 claims · 0.4%

Your Cost: $60.35/claim|Median: $36.79
1.6× median
99204Top 25%

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

$36K

281 claims · 0.4%

Your Cost: $126.84/claim|Median: $84.03
1.5× median
92586Normal range

$30K

430 claims · 0.3%

Your Cost: $69.44/claim|Median: $51.18
1.4× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$25K

249 claims · 0.3%

Your Cost: $101.45/claim|Median: $111.09
0.9× median
59025Normal range

Fetal non-stress test

$17K

853 claims · 0.2%

Your Cost: $19.36/claim|Median: $26.45
0.7× median
76801Normal range

Ultrasound, pregnant uterus, single fetus, first trimester

$9K

132 claims · 0.1%

Your Cost: $67.66/claim|Median: $58.16
1.2× median
99203Top 25%

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

$9K

93 claims · 0.1%

Your Cost: $95.61/claim|Median: $57.85
1.7× median
99242Top 25%

Office consultation, low complexity

$7K

93 claims · 0.1%

Your Cost: $74.12/claim|Median: $57.97
1.3× median
99232Top 5%

Subsequent hospital care, per day, moderate complexity

$6K

100 claims · 0.1%

Your Cost: $60.73/claim|Median: $23.99
2.5× median
99245Normal range

Office consultation, high complexity

$5K

30 claims · 0.1%

Your Cost: $168.77/claim|Median: $143.30
1.2× median
90715Top 25%

Tdap vaccine

$2K

102 claims · 0.0%

Your Cost: $23.23/claim|Median: $10.32
2.3× median
99212Normal range

Office/outpatient visit, low complexity

$2K

49 claims · 0.0%

Your Cost: $35.32/claim|Median: $25.06
1.4× median
99221Top 10%

Initial hospital care, straightforward/low

$1K

16 claims · 0.0%

Your Cost: $88.49/claim|Median: $39.96
2.2× median
99231Top 10%

Subsequent hospital care, per day, low complexity

$1K

30 claims · 0.0%

Your Cost: $34.02/claim|Median: $16.77
2.0× median
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