Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

⚖️ Compare🖨️ Print Report

Provider 1497700736

NPI: 1497700736Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$15.6M

$15,637,589

Total Claims

895K

Beneficiaries

785K

1.1 claims/patient

Avg Cost/Claim

$17

Monthly Spending Trend

Yearly Spending

2018
$1.4M
+54%
2019
$2.2M
+34%
2020
$3.0M
+12%
2021
$3.3M
-43%
2022
$1.9M
-15%
2023
$1.6M
+31%
2024
$2.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 52% of total spending.

99213Normal range

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

$8.1M

203K claims · 51.6%

Your Cost: $39.73/claim|Median: $37.81
1.1× median
99214Normal range

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

$967K

22K claims · 6.2%

Your Cost: $43.48/claim|Median: $53.41
0.8× median
99212Normal range

Office/outpatient visit, low complexity

$761K

22K claims · 4.9%

Your Cost: $33.83/claim|Median: $25.06
1.3× median
99442Normal range

Telephone E/M by physician, 11-20 minutes

$524K

16K claims · 3.4%

Your Cost: $33.47/claim|Median: $22.44
1.5× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$517K

35K claims · 3.3%

Your Cost: $14.60/claim|Median: $17.85
0.8× median
99393Normal range

Preventive medicine, established patient, age 5-11

$470K

13K claims · 3.0%

Your Cost: $36.17/claim|Median: $74.82
0.5× median
99392Normal range

Preventive medicine, established patient, age 1-4

$370K

10K claims · 2.4%

Your Cost: $35.86/claim|Median: $75.18
0.5× median
99443Normal range

Telephone E/M by physician, 21-30 min

$323K

8,658 claims · 2.1%

Your Cost: $37.34/claim|Median: $32.55
1.1× median
99395Normal range

Preventive medicine, established patient, age 18-39

$317K

5,784 claims · 2.0%

Your Cost: $54.81/claim|Median: $72.71
0.8× median
99394Normal range

Preventive medicine, established patient, age 12-17

$290K

8,243 claims · 1.9%

Your Cost: $35.23/claim|Median: $80.15
0.4× median
99396Normal range

Preventive medicine, established patient, age 40-64

$268K

5,550 claims · 1.7%

Your Cost: $48.29/claim|Median: $76.06
0.6× median
G0511Top 1%

RHC/FQHC visit, psychiatric collaborative care model

$224K

1,759 claims · 1.4%

Your Cost: $127.22/claim|Median: $11.35
11.2× median
92502Normal range

$217K

6,601 claims · 1.4%

Your Cost: $32.81/claim|Median: $42.87
0.8× median
99497Top 10%

$189K

3,573 claims · 1.2%

Your Cost: $52.98/claim|Median: $10.99
4.8× median
D1110Normal range

Prophylaxis, adult cleaning

$159K

4,097 claims · 1.0%

Your Cost: $38.83/claim|Median: $43.38
0.9× median
97802Normal range

Medical nutrition therapy, reassessment, individual, fifteen minutes

$155K

30K claims · 1.0%

Your Cost: $5.12/claim|Median: $12.70
0.4× median
G0447Normal range

$138K

12K claims · 0.9%

Your Cost: $11.02/claim|Median: $5.19
2.1× median
99441Top 25%

Telephone E/M by physician, 5-10 min

$135K

4,106 claims · 0.9%

Your Cost: $32.81/claim|Median: $13.30
2.5× median
99215Normal range

Office/outpatient visit, high complexity

$134K

1,337 claims · 0.9%

Your Cost: $100.02/claim|Median: $74.09
1.3× median
D0140Top 10%

Limited oral evaluation, problem focused

$130K

2,817 claims · 0.8%

Your Cost: $46.04/claim|Median: $27.07
1.7× median
99203Normal range

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

$108K

1,400 claims · 0.7%

Your Cost: $77.49/claim|Median: $57.85
1.3× median
99401Normal range

$95K

13K claims · 0.6%

Your Cost: $7.27/claim|Median: $16.53
0.4× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$93K

2,472 claims · 0.6%

Your Cost: $37.66/claim|Median: $69.35
0.5× median
92551Normal range

Screening audiometry, pure tone, air only

$91K

22K claims · 0.6%

Your Cost: $4.11/claim|Median: $6.61
0.6× median
90471Normal range

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

$87K

11K claims · 0.6%

Your Cost: $8.04/claim|Median: $9.80
0.8× median
99204Top 25%

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

$78K

656 claims · 0.5%

Your Cost: $119.38/claim|Median: $84.03
1.4× median
92002Top 10%

Intermediate eye exam, new patient

$71K

989 claims · 0.5%

Your Cost: $71.64/claim|Median: $41.61
1.7× median
92012Top 10%

Ophthalmological exam, intermediate, established patient

$57K

798 claims · 0.4%

Your Cost: $71.67/claim|Median: $38.23
1.9× median
99173Normal range

$43K

21K claims · 0.3%

Your Cost: $2.09/claim|Median: $2.16
1.0× median
D4355Normal range

$38K

1,550 claims · 0.2%

Your Cost: $24.43/claim|Median: $64.42
0.4× median
← All providersHow we detect fraud →