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Provider 1417972282

NPI: 1417972282Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$10.9M

$10,876,502

Total Claims

166K

Beneficiaries

139K

1.2 claims/patient

Avg Cost/Claim

$66

Monthly Spending Trend

Yearly Spending

2018
$2.2M
-28%
2019
$1.6M
+16%
2020
$1.8M
-7%
2021
$1.7M
-40%
2022
$1.0M
+47%
2023
$1.5M
-18%
2024
$1.2M

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 94% of total spending.

T1015Top 10%

Clinic visit/encounter, all-inclusive

$10.2M

41K claims · 93.5%

Your Cost: $249.91/claim|Median: $121.16
2.1× median
G0467Top 5%

Federally qualified health center visit, mental health

$621K

2,941 claims · 5.7%

Your Cost: $211.05/claim|Median: $21.91
9.6× median
99213Normal range

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

$51K

38K claims · 0.5%

Your Cost: $1.33/claim|Median: $37.81
0.0× median
99214Normal range

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

$17K

16K claims · 0.2%

Your Cost: $1.11/claim|Median: $53.41
0.0× median
99212Normal range

Office/outpatient visit, low complexity

$3K

2,852 claims · 0.0%

Your Cost: $1.21/claim|Median: $25.06
0.0× median
0012ANormal range

COVID-19 vaccine admin, Moderna, 2nd dose

$2K

115 claims · 0.0%

Your Cost: $21.04/claim|Median: $33.85
0.6× median
99392Normal range

Preventive medicine, established patient, age 1-4

$2K

1,342 claims · 0.0%

Your Cost: $1.57/claim|Median: $75.18
0.0× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$1K

3,189 claims · 0.0%

Your Cost: $0.43/claim|Median: $7.18
0.1× median
99393Normal range

Preventive medicine, established patient, age 5-11

$855

1,334 claims · 0.0%

Your Cost: $0.64/claim|Median: $74.82
0.0× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$722

305 claims · 0.0%

Your Cost: $2.37/claim|Median: $69.35
0.0× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$648

2,403 claims · 0.0%

Your Cost: $0.27/claim|Median: $9.56
0.0× median
90746Normal range

Hepatitis B vaccine, adult

$546

516 claims · 0.0%

Your Cost: $1.06/claim|Median: $48.85
0.0× median
99215Normal range

Office/outpatient visit, high complexity

$502

114 claims · 0.0%

Your Cost: $4.40/claim|Median: $74.09
0.1× median
90715Normal range

Tdap vaccine

$389

583 claims · 0.0%

Your Cost: $0.67/claim|Median: $10.32
0.1× median
83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$335

3,017 claims · 0.0%

Your Cost: $0.11/claim|Median: $5.50
0.0× median
90471Normal range

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

$326

3,122 claims · 0.0%

Your Cost: $0.10/claim|Median: $9.80
0.0× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$326

209 claims · 0.0%

Your Cost: $1.56/claim|Median: $39.70
0.0× median
90688Normal range

$229

448 claims · 0.0%

Your Cost: $0.51/claim|Median: $9.00
0.1× median
99395Normal range

Preventive medicine, established patient, age 18-39

$211

163 claims · 0.0%

Your Cost: $1.29/claim|Median: $72.71
0.0× median
85018Normal range

$198

1,720 claims · 0.0%

Your Cost: $0.12/claim|Median: $1.71
0.1× median
99394Normal range

Preventive medicine, established patient, age 12-17

$173

613 claims · 0.0%

Your Cost: $0.28/claim|Median: $80.15
0.0× median
90656Normal range

$153

358 claims · 0.0%

Your Cost: $0.43/claim|Median: $8.67
0.0× median
92552Normal range

Pure tone audiometry, air only, each ear

$139

1,378 claims · 0.0%

Your Cost: $0.10/claim|Median: $12.63
0.0× median
99204Normal range

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

$138

37 claims · 0.0%

Your Cost: $3.72/claim|Median: $84.03
0.0× median
90674Normal range

$98

30 claims · 0.0%

Your Cost: $3.28/claim|Median: $15.16
0.2× median
90716Normal range

$76

194 claims · 0.0%

Your Cost: $0.39/claim|Median: $6.18
0.1× median
0011ANormal range

COVID-19 vaccine admin, Moderna, 1st dose

$39

57 claims · 0.0%

Your Cost: $0.69/claim|Median: $25.93
0.0× median
90670Normal range

$38

290 claims · 0.0%

Your Cost: $0.13/claim|Median: $5.94
0.0× median
90707Normal range

MMR vaccine

$38

185 claims · 0.0%

Your Cost: $0.20/claim|Median: $5.76
0.0× median
J3301Normal range

Injection, triamcinolone acetonide, per ten milligrams

$34

150 claims · 0.0%

Your Cost: $0.22/claim|Median: $2.91
0.1× median
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