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SOMC MEDICAL CARE FOUNDATION, INC.

Family Medicine·PORTSMOUTH, OH·NPI: 1457467227Share

Compared to Family Medicine Peers

Total spending distribution among 19 providers in this specialty

P25MedianP75P90

This provider's total spending of $25.3M is at the 75th percentile among 19 Family Medicine providers.

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

Total Paid

$25.3M

$25,286,958

Total Claims

1.1M

Beneficiaries

924K

1.1 claims/patient

Avg Cost/Claim

$24

Monthly Spending Trend

Yearly Spending

2018
$2.6M
+22%
2019
$3.2M
-4%
2020
$3.1M
+28%
2021
$3.9M
+8%
2022
$4.2M
+4%
2023
$4.4M
-8%
2024
$4.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 40% of total spending.

99214Normal range

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

$10.2M

335K claims · 40.3%

Your Cost: $30.43/claim|Median: $53.41
0.6× median
99213Normal range

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

$8.0M

369K claims · 31.8%

Your Cost: $21.80/claim|Median: $37.81
0.6× median
88305Normal range

Surgical pathology, gross and microscopic examination

$534K

24K claims · 2.1%

Your Cost: $22.62/claim|Median: $35.80
0.6× median
99223Normal range

Initial hospital care, per day, high complexity

$437K

11K claims · 1.7%

Your Cost: $41.52/claim|Median: $67.32
0.6× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$415K

15K claims · 1.6%

Your Cost: $27.41/claim|Median: $69.35
0.4× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$399K

30K claims · 1.6%

Your Cost: $13.32/claim|Median: $23.99
0.6× median
93010Normal range

Electrocardiogram, interpretation and report only

$378K

67K claims · 1.5%

Your Cost: $5.65/claim|Median: $5.60
1.0× median
99392Normal range

Preventive medicine, established patient, age 1-4

$339K

10K claims · 1.3%

Your Cost: $33.66/claim|Median: $75.18
0.4× median
99204Normal range

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

$332K

7,018 claims · 1.3%

Your Cost: $47.28/claim|Median: $84.03
0.6× median
93306Normal range

Echocardiography, transthoracic, complete, with Doppler

$331K

11K claims · 1.3%

Your Cost: $30.93/claim|Median: $54.68
0.6× median
43239Normal range

Upper GI endoscopy with biopsy

$292K

3,253 claims · 1.2%

Your Cost: $89.91/claim|Median: $151.68
0.6× median
93458Normal range

Left heart catheterization with imaging

$238K

2,556 claims · 0.9%

Your Cost: $93.04/claim|Median: $183.33
0.5× median
99203Normal range

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

$226K

8,178 claims · 0.9%

Your Cost: $27.65/claim|Median: $57.85
0.5× median
90837Normal range

Psychotherapy, 60 minutes

$211K

3,587 claims · 0.8%

Your Cost: $58.92/claim|Median: $85.66
0.7× median
99215Normal range

Office/outpatient visit, high complexity

$172K

5,534 claims · 0.7%

Your Cost: $31.02/claim|Median: $74.09
0.4× median
99233Normal range

Subsequent hospital care, per day, high complexity

$161K

8,867 claims · 0.6%

Your Cost: $18.13/claim|Median: $35.30
0.5× median
99212Normal range

Office/outpatient visit, low complexity

$159K

9,788 claims · 0.6%

Your Cost: $16.21/claim|Median: $25.06
0.6× median
20610Normal range

Arthrocentesis, aspiration/injection, major joint

$153K

7,091 claims · 0.6%

Your Cost: $21.54/claim|Median: $29.03
0.7× median
99222Normal range

Initial hospital care, per day, moderate complexity

$143K

4,911 claims · 0.6%

Your Cost: $29.18/claim|Median: $51.25
0.6× median
45380Normal range

Colonoscopy with biopsy

$127K

968 claims · 0.5%

Your Cost: $131.18/claim|Median: $200.68
0.7× median
11042Normal range

Debridement, subcutaneous tissue, first 20 sq cm

$115K

9,948 claims · 0.5%

Your Cost: $11.59/claim|Median: $36.13
0.3× median
95810Normal range

Polysomnography, sleep study, 6+ hours

$101K

1,746 claims · 0.4%

Your Cost: $57.70/claim|Median: $233.73
0.2× median
92928Normal range

$93K

635 claims · 0.4%

Your Cost: $146.36/claim|Median: $224.97
0.7× median
95886Normal range

$88K

4,707 claims · 0.3%

Your Cost: $18.62/claim|Median: $67.70
0.3× median
95913Normal range

$87K

787 claims · 0.3%

Your Cost: $110.82/claim|Median: $166.25
0.7× median
93298Normal range

$84K

5,594 claims · 0.3%

Your Cost: $15.10/claim|Median: $14.28
1.1× median
99393Normal range

Preventive medicine, established patient, age 5-11

$81K

2,464 claims · 0.3%

Your Cost: $33.00/claim|Median: $74.82
0.4× median
90833Normal range

Psychotherapy, 30 min, add-on to E/M service

$75K

3,328 claims · 0.3%

Your Cost: $22.64/claim|Median: $38.83
0.6× median
95811Normal range

Sleep study with CPAP titration, polysomnography

$68K

1,100 claims · 0.3%

Your Cost: $61.93/claim|Median: $255.03
0.2× median
99395Normal range

Preventive medicine, established patient, age 18-39

$58K

1,637 claims · 0.2%

Your Cost: $35.44/claim|Median: $72.71
0.5× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$57K

3,173 claims · 0.2%

Your Cost: $18.02/claim|Median: $40.11
0.4× median
93016Normal range

$46K

3,465 claims · 0.2%

Your Cost: $13.29/claim|Median: $12.24
1.1× median
88307Normal range

Surgical pathology, gross and microscopic, complex

$43K

979 claims · 0.2%

Your Cost: $43.87/claim|Median: $59.38
0.7× median
95911Normal range

$42K

746 claims · 0.2%

Your Cost: $56.38/claim|Median: $122.86
0.5× median
99441Normal range

Telephone E/M by physician, 5-10 min

$42K

4,549 claims · 0.2%

Your Cost: $9.22/claim|Median: $13.30
0.7× median
95912Normal range

$37K

509 claims · 0.1%

Your Cost: $72.83/claim|Median: $141.23
0.5× median
99394Normal range

Preventive medicine, established patient, age 12-17

$36K

975 claims · 0.1%

Your Cost: $36.66/claim|Median: $80.15
0.5× median
99442Normal range

Telephone E/M by physician, 11-20 minutes

$35K

2,190 claims · 0.1%

Your Cost: $15.95/claim|Median: $22.44
0.7× median
95816Normal range

$34K

1,467 claims · 0.1%

Your Cost: $22.84/claim|Median: $56.87
0.4× median
93018Normal range

$33K

3,748 claims · 0.1%

Your Cost: $8.81/claim|Median: $8.92
1.0× median
99308Normal range

Nursing facility care, subsequent, straightforward

$33K

4,149 claims · 0.1%

Your Cost: $7.90/claim|Median: $9.79
0.8× median
92978Normal range

$31K

769 claims · 0.1%

Your Cost: $40.84/claim|Median: $58.79
0.7× median
88342Normal range

$30K

1,738 claims · 0.1%

Your Cost: $17.37/claim|Median: $23.66
0.7× median
99291Normal range

Critical care, first 30-74 minutes

$29K

785 claims · 0.1%

Your Cost: $37.19/claim|Median: $101.24
0.4× median
88304Normal range

$26K

3,927 claims · 0.1%

Your Cost: $6.60/claim|Median: $12.88
0.5× median
94060Normal range

$24K

2,214 claims · 0.1%

Your Cost: $10.68/claim|Median: $25.18
0.4× median
99406Normal range

$23K

5,156 claims · 0.1%

Your Cost: $4.53/claim|Median: $6.53
0.7× median
99152Normal range

$22K

4,379 claims · 0.1%

Your Cost: $4.95/claim|Median: $7.34
0.7× median
87502Normal range

Influenza virus detection, reverse transcription, amplified probe

$21K

352 claims · 0.1%

Your Cost: $60.02/claim|Median: $65.64
0.9× median
45385Normal range

Colonoscopy with polyp removal, snare technique

$20K

104 claims · 0.1%

Your Cost: $189.95/claim|Median: $255.17
0.7× median

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The Metrohealth System

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$574.1M

Children's Hospital Medical Center of Akron

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$556.6M

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