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PRIMARY PEDIATRICS, PC

Specialist·MACON, GA·NPI: 1477638575Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$32.9M

$32,935,904

Total Claims

874K

Beneficiaries

812K

1.1 claims/patient

Avg Cost/Claim

$38

Monthly Spending Trend

Yearly Spending

2018
$9.0M
-21%
2019
$7.1M
-53%
2020
$3.3M
-6%
2021
$3.1M
+39%
2022
$4.3M
-17%
2023
$3.6M
-34%
2024
$2.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 44% of total spending.

99213Top 25%

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

$14.5M

219K claims · 44.0%

Your Cost: $66.29/claim|Median: $37.81
1.8× median
99392Top 25%

Preventive medicine, established patient, age 1-4

$3.1M

30K claims · 9.4%

Your Cost: $101.90/claim|Median: $75.18
1.4× median
90460Top 5%

Immunization administration, first vaccine/toxoid, with counseling

$2.9M

56K claims · 8.9%

Your Cost: $52.65/claim|Median: $17.85
2.9× median
99391Top 25%

Preventive medicine, established patient, infant (under 1)

$2.6M

28K claims · 8.0%

Your Cost: $94.67/claim|Median: $69.35
1.4× median
99393Top 25%

Preventive medicine, established patient, age 5-11

$2.2M

21K claims · 6.7%

Your Cost: $102.34/claim|Median: $74.82
1.4× median
99394Top 25%

Preventive medicine, established patient, age 12-17

$1.4M

12K claims · 4.2%

Your Cost: $111.86/claim|Median: $80.15
1.4× median
99212Top 25%

Office/outpatient visit, low complexity

$938K

22K claims · 2.8%

Your Cost: $41.91/claim|Median: $25.06
1.7× median
87804Normal range

Influenza virus detection, rapid test

$852K

56K claims · 2.6%

Your Cost: $15.33/claim|Median: $12.59
1.2× median
99050Top 25%

$764K

43K claims · 2.3%

Your Cost: $17.84/claim|Median: $11.81
1.5× median
99214Top 25%

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

$751K

7,634 claims · 2.3%

Your Cost: $98.33/claim|Median: $53.41
1.8× median
99051Top 25%

$511K

29K claims · 1.6%

Your Cost: $17.68/claim|Median: $7.89
2.2× median
87880Top 25%

Streptococcus, Group A, rapid antigen detection

$469K

31K claims · 1.4%

Your Cost: $15.14/claim|Median: $11.48
1.3× median
87426Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$397K

11K claims · 1.2%

Your Cost: $34.61/claim|Median: $30.04
1.2× median
87070Top 25%

Bacterial culture, any source except blood or urine

$237K

22K claims · 0.7%

Your Cost: $10.80/claim|Median: $5.89
1.8× median
99203Top 10%

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

$172K

1,654 claims · 0.5%

Your Cost: $103.71/claim|Median: $57.85
1.8× median
99460Top 25%

Initial hospital or birthing center care, newborn, per day

$150K

1,680 claims · 0.5%

Your Cost: $89.05/claim|Median: $62.48
1.4× median
96110Normal range

Developmental screening, per standardized instrument

$137K

11K claims · 0.4%

Your Cost: $12.15/claim|Median: $9.10
1.3× median
99283Normal range

Emergency dept visit, moderate complexity

$135K

2,259 claims · 0.4%

Your Cost: $59.88/claim|Median: $42.48
1.4× median
99238Top 10%

Hospital discharge day management, 30 minutes or less

$103K

1,509 claims · 0.3%

Your Cost: $68.57/claim|Median: $37.22
1.8× median
85025Top 25%

Complete blood count (CBC) with differential, automated

$88K

9,188 claims · 0.3%

Your Cost: $9.60/claim|Median: $4.71
2.0× median
90471Top 5%

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

$77K

3,434 claims · 0.2%

Your Cost: $22.53/claim|Median: $9.80
2.3× median
99204Top 10%

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

$77K

501 claims · 0.2%

Your Cost: $152.89/claim|Median: $84.03
1.8× median
83655Normal range

$70K

6,643 claims · 0.2%

Your Cost: $10.48/claim|Median: $10.49
1.0× median
87807Top 10%

$51K

3,362 claims · 0.2%

Your Cost: $15.23/claim|Median: $10.06
1.5× median
95165Normal range

Professional services for allergen immunotherapy, per injection

$22K

122 claims · 0.1%

Your Cost: $181.94/claim|Median: $144.04
1.3× median
87428Top 25%

SARS-CoV-2 COVID-19 antigen detection, immunoassay, each

$21K

348 claims · 0.1%

Your Cost: $60.92/claim|Median: $39.63
1.5× median
81000Top 10%

Urinalysis with microscopy, non-automated

$16K

4,024 claims · 0.0%

Your Cost: $3.90/claim|Median: $2.51
1.6× median
99429Normal range

$15K

757 claims · 0.0%

Your Cost: $20.36/claim|Median: $28.58
0.7× median
87086Top 25%

Urine culture, colony count, with identification

$15K

1,586 claims · 0.0%

Your Cost: $9.54/claim|Median: $5.31
1.8× median
94640Top 25%

Pressurized or nonpressurized inhalation treatment

$15K

776 claims · 0.0%

Your Cost: $19.48/claim|Median: $10.88
1.8× median
96160Top 25%

Patient-focused health risk assessment

$14K

3,564 claims · 0.0%

Your Cost: $4.01/claim|Median: $2.10
1.9× median
94760Top 10%

Pulse oximetry, single reading, noninvasive

$12K

1,607 claims · 0.0%

Your Cost: $7.62/claim|Median: $0.79
9.6× median
90651Normal range

HPV vaccine, 9-valent

$8K

4,373 claims · 0.0%

Your Cost: $1.88/claim|Median: $8.93
0.2× median
99284Top 25%

Emergency dept visit, high complexity

$7K

78 claims · 0.0%

Your Cost: $95.76/claim|Median: $69.51
1.4× median
90716Normal range

$6K

7,919 claims · 0.0%

Your Cost: $0.73/claim|Median: $6.18
0.1× median
82247Top 25%

$5K

812 claims · 0.0%

Your Cost: $6.55/claim|Median: $2.74
2.4× median
99285Top 25%

Emergency dept visit, high/urgent complexity

$4K

33 claims · 0.0%

Your Cost: $131.52/claim|Median: $85.65
1.5× median
0072ANormal range

$4K

108 claims · 0.0%

Your Cost: $40.03/claim|Median: $39.57
1.0× median
0071ANormal range

$4K

107 claims · 0.0%

Your Cost: $39.64/claim|Median: $38.71
1.0× median
99395Top 10%

Preventive medicine, established patient, age 18-39

$3K

29 claims · 0.0%

Your Cost: $115.52/claim|Median: $72.71
1.6× median
90707Normal range

MMR vaccine

$3K

7,461 claims · 0.0%

Your Cost: $0.42/claim|Median: $5.76
0.1× median
90472Top 25%

Immunization administration, each additional vaccine

$3K

159 claims · 0.0%

Your Cost: $19.45/claim|Median: $11.79
1.6× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$3K

614 claims · 0.0%

Your Cost: $4.80/claim|Median: $3.67
1.3× median
99205Top 25%

Office/outpatient visit, new patient, high complexity

$2K

13 claims · 0.0%

Your Cost: $178.04/claim|Median: $111.09
1.6× median
87636Normal range

Respiratory virus detection, 6-11 targets, nucleic acid

$2K

19 claims · 0.0%

Your Cost: $105.10/claim|Median: $97.61
1.1× median
86308Top 25%

$2K

257 claims · 0.0%

Your Cost: $6.51/claim|Median: $3.84
1.7× median
99381Top 25%

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

$1K

14 claims · 0.0%

Your Cost: $102.82/claim|Median: $73.46
1.4× median
81025Top 25%

Urine pregnancy test

$1K

179 claims · 0.0%

Your Cost: $7.98/claim|Median: $4.81
1.7× median
90620Normal range

$1K

933 claims · 0.0%

Your Cost: $1.53/claim|Median: $6.49
0.2× median
0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$1K

31 claims · 0.0%

Your Cost: $40.03/claim|Median: $36.70
1.1× median

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