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Provider 1417902362

NPI: 1417902362Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$12.3M

$12,281,324

Total Claims

120K

Beneficiaries

108K

1.1 claims/patient

Avg Cost/Claim

$103

Monthly Spending Trend

Yearly Spending

2018
$203K
+130%
2019
$468K
+208%
2020
$1.4M
+115%
2021
$3.1M
-21%
2022
$2.4M
-2%
2023
$2.4M
-8%
2024
$2.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 99% of total spending.

T1015Top 25%

Clinic visit/encounter, all-inclusive

$12.2M

59K claims · 99.0%

Your Cost: $205.04/claim|Median: $121.16
1.7× median
0012ANormal range

COVID-19 vaccine admin, Moderna, 2nd dose

$22K

559 claims · 0.2%

Your Cost: $38.92/claim|Median: $33.85
1.1× median
0011ANormal range

COVID-19 vaccine admin, Moderna, 1st dose

$18K

539 claims · 0.1%

Your Cost: $32.59/claim|Median: $25.93
1.3× median
99499Normal range

Unlisted evaluation and management service

$10K

1,753 claims · 0.1%

Your Cost: $5.59/claim|Median: $30.88
0.2× median
0064ANormal range

$8K

217 claims · 0.1%

Your Cost: $38.16/claim|Median: $34.17
1.1× median
0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$8K

205 claims · 0.1%

Your Cost: $39.41/claim|Median: $36.70
1.1× median
99214Normal range

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

$8K

16K claims · 0.1%

Your Cost: $0.48/claim|Median: $53.41
0.0× median
0072ANormal range

$8K

202 claims · 0.1%

Your Cost: $38.22/claim|Median: $39.57
1.0× median
G2025Normal range

$8K

384 claims · 0.1%

Your Cost: $19.82/claim|Median: $15.63
1.3× median
0071ANormal range

$6K

173 claims · 0.0%

Your Cost: $34.68/claim|Median: $38.71
0.9× median
0001ANormal range

COVID-19 vaccine admin, Pfizer, 1st dose

$5K

126 claims · 0.0%

Your Cost: $38.10/claim|Median: $33.72
1.1× median
99213Normal range

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

$4K

9,819 claims · 0.0%

Your Cost: $0.43/claim|Median: $37.81
0.0× median
3725FTop 10%

$4K

1,115 claims · 0.0%

Your Cost: $3.73/claim|Median: $0.03
124.2× median
G0467Top 25%

Federally qualified health center visit, mental health

$2K

42 claims · 0.0%

Your Cost: $56.71/claim|Median: $21.91
2.6× median
0054ANormal range

$2K

51 claims · 0.0%

Your Cost: $33.73/claim|Median: $35.83
0.9× median
90480Normal range

$1K

143 claims · 0.0%

Your Cost: $9.16/claim|Median: $25.29
0.4× median
0004ANormal range

$1K

43 claims · 0.0%

Your Cost: $29.77/claim|Median: $35.62
0.8× median
3078FTop 5%

$1K

222 claims · 0.0%

Your Cost: $5.05/claim|Median: $0.08
63.1× median
3074FTop 5%

$990

184 claims · 0.0%

Your Cost: $5.38/claim|Median: $0.11
48.9× median
0134ANormal range

$920

41 claims · 0.0%

Your Cost: $22.44/claim|Median: $33.54
0.7× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$876

2,690 claims · 0.0%

Your Cost: $0.33/claim|Median: $17.85
0.0× median
0124ANormal range

$560

17 claims · 0.0%

Your Cost: $32.94/claim|Median: $34.32
1.0× median
90471Normal range

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

$524

2,232 claims · 0.0%

Your Cost: $0.23/claim|Median: $9.80
0.0× median
3079FTop 5%

$490

88 claims · 0.0%

Your Cost: $5.57/claim|Median: $0.12
46.4× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$427

2,462 claims · 0.0%

Your Cost: $0.17/claim|Median: $7.18
0.0× median
99212Normal range

Office/outpatient visit, low complexity

$257

3,447 claims · 0.0%

Your Cost: $0.07/claim|Median: $25.06
0.0× median
3075FTop 5%

$210

35 claims · 0.0%

Your Cost: $6.00/claim|Median: $0.15
40.0× median
3077FTop 10%

$110

26 claims · 0.0%

Your Cost: $4.23/claim|Median: $0.12
35.3× median
92551Normal range

Screening audiometry, pure tone, air only

$40

2,249 claims · 0.0%

Your Cost: $0.02/claim|Median: $6.61
0.0× median
99173Normal range

$36

2,763 claims · 0.0%

Your Cost: $0.01/claim|Median: $2.16
0.0× median
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