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PEDIATRIX MEDICAL GROUP OF TENNESSEE, P.C.

Pediatrics, Neonatal-Perinatal Medicine·NASHVILLE, TN·NPI: 1497852107Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$32.3M

$32,293,570

Total Claims

473K

Beneficiaries

330K

1.4 claims/patient

Avg Cost/Claim

$68

Monthly Spending Trend

Yearly Spending

2018
$5.8M
-34%
2019
$3.8M
+11%
2020
$4.3M
+3%
2021
$4.4M
+9%
2022
$4.8M
+19%
2023
$5.7M
-38%
2024
$3.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99469 (Subsequent intensive care, very low birth weight infant)) accounts for 24% of total spending.

99469Normal range

Subsequent intensive care, very low birth weight infant

$7.8M

27K claims · 24.2%

Your Cost: $287.15/claim|Median: $293.45
1.0× median
99479Normal range

Subsequent intensive care, 2,501-5,000 grams

$5.6M

63K claims · 17.4%

Your Cost: $88.37/claim|Median: $103.70
0.9× median
99480Normal range

Subsequent intensive care, very low birth weight infant

$4.9M

56K claims · 15.1%

Your Cost: $87.76/claim|Median: $98.15
0.9× median
92586Normal range

$2.2M

61K claims · 6.8%

Your Cost: $35.64/claim|Median: $51.18
0.7× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$1.8M

36K claims · 5.5%

Your Cost: $49.81/claim|Median: $37.22
1.3× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$1.6M

32K claims · 4.9%

Your Cost: $48.60/claim|Median: $62.48
0.8× median
92650Normal range

$1.5M

65K claims · 4.7%

Your Cost: $23.10/claim|Median: $31.90
0.7× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$610K

14K claims · 1.9%

Your Cost: $45.06/claim|Median: $58.55
0.8× median
76819Normal range

Fetal biophysical profile with non-stress test

$443K

9,302 claims · 1.4%

Your Cost: $47.61/claim|Median: $49.45
1.0× median
93306Top 25%

Echocardiography, transthoracic, complete, with Doppler

$435K

2,462 claims · 1.3%

Your Cost: $176.86/claim|Median: $54.68
3.2× median
93303Normal range

Echocardiography, transthoracic, limited

$428K

3,508 claims · 1.3%

Your Cost: $122.03/claim|Median: $112.83
1.1× median
99283Normal range

Emergency dept visit, moderate complexity

$367K

8,869 claims · 1.1%

Your Cost: $41.42/claim|Median: $42.48
1.0× median
76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$330K

2,811 claims · 1.0%

Your Cost: $117.37/claim|Median: $106.79
1.1× median
99472Normal range

Subsequent pediatric critical care, per day, age 2-5

$327K

1,114 claims · 1.0%

Your Cost: $293.15/claim|Median: $307.98
1.0× median
93325Top 25%

$313K

6,545 claims · 1.0%

Your Cost: $47.79/claim|Median: $14.61
3.3× median
76805Normal range

Ultrasound, pregnant uterus, complete, single fetus

$303K

4,908 claims · 0.9%

Your Cost: $61.66/claim|Median: $74.78
0.8× median
99213Normal range

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

$280K

6,888 claims · 0.9%

Your Cost: $40.66/claim|Median: $37.81
1.1× median
99284Normal range

Emergency dept visit, high complexity

$273K

4,421 claims · 0.8%

Your Cost: $61.82/claim|Median: $69.51
0.9× median
54150Normal range

$269K

2,245 claims · 0.8%

Your Cost: $119.99/claim|Median: $84.60
1.4× median
76817Normal range

Ultrasound, pregnant uterus, transvaginal

$238K

4,788 claims · 0.7%

Your Cost: $49.67/claim|Median: $47.65
1.0× median
99462Normal range

$236K

9,685 claims · 0.7%

Your Cost: $24.35/claim|Median: $27.49
0.9× median
99239Top 25%

Hospital discharge day management, more than 30 minutes

$221K

3,081 claims · 0.7%

Your Cost: $71.70/claim|Median: $43.85
1.6× median
99468Normal range

$154K

237 claims · 0.5%

Your Cost: $649.69/claim|Median: $679.18
1.0× median
76801Normal range

Ultrasound, pregnant uterus, single fetus, first trimester

$150K

2,611 claims · 0.5%

Your Cost: $57.30/claim|Median: $58.16
1.0× median
93320Normal range

$146K

3,510 claims · 0.5%

Your Cost: $41.49/claim|Median: $28.68
1.4× median
59410Normal range

$103K

165 claims · 0.3%

Your Cost: $624.07/claim|Median: $781.64
0.8× median
59400Normal range

Routine obstetric care, vaginal delivery, including postpartum

$102K

96 claims · 0.3%

Your Cost: $1,067.51/claim|Median: $1,482.45
0.7× median
76830Normal range

Ultrasound, transvaginal

$94K

2,266 claims · 0.3%

Your Cost: $41.69/claim|Median: $57.47
0.7× median
93304Normal range

$81K

971 claims · 0.3%

Your Cost: $83.27/claim|Median: $54.29
1.5× median
76820Normal range

$80K

2,139 claims · 0.2%

Your Cost: $37.41/claim|Median: $31.79
1.2× median
99204Normal range

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

$79K

887 claims · 0.2%

Your Cost: $88.77/claim|Median: $84.03
1.1× median
99214Normal range

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

$73K

1,111 claims · 0.2%

Your Cost: $65.79/claim|Median: $53.41
1.2× median
99203Normal range

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

$69K

1,183 claims · 0.2%

Your Cost: $58.00/claim|Median: $57.85
1.0× median
99282Normal range

Emergency dept visit, low complexity

$59K

2,362 claims · 0.2%

Your Cost: $25.04/claim|Median: $37.72
0.7× median
93000Top 25%

Electrocardiogram, complete, with interpretation and report

$59K

3,422 claims · 0.2%

Your Cost: $17.10/claim|Median: $9.70
1.8× median
99222Top 25%

Initial hospital care, per day, moderate complexity

$54K

637 claims · 0.2%

Your Cost: $84.30/claim|Median: $51.25
1.6× median
99395Normal range

Preventive medicine, established patient, age 18-39

$47K

673 claims · 0.1%

Your Cost: $69.13/claim|Median: $72.71
1.0× median
93321Top 25%

$42K

1,637 claims · 0.1%

Your Cost: $25.49/claim|Median: $9.69
2.6× median
99463Normal range

$41K

660 claims · 0.1%

Your Cost: $61.99/claim|Median: $78.46
0.8× median
76815Normal range

Ultrasound, pregnant uterus, limited

$40K

1,096 claims · 0.1%

Your Cost: $36.05/claim|Median: $36.79
1.0× median
99464Normal range

$39K

683 claims · 0.1%

Your Cost: $57.24/claim|Median: $59.94
1.0× median
59025Normal range

Fetal non-stress test

$39K

1,901 claims · 0.1%

Your Cost: $20.51/claim|Median: $26.45
0.8× median
93010Normal range

Electrocardiogram, interpretation and report only

$36K

4,848 claims · 0.1%

Your Cost: $7.41/claim|Median: $5.60
1.3× median
99212Normal range

Office/outpatient visit, low complexity

$33K

1,343 claims · 0.1%

Your Cost: $24.33/claim|Median: $25.06
1.0× median
99232Top 25%

Subsequent hospital care, per day, moderate complexity

$30K

656 claims · 0.1%

Your Cost: $45.52/claim|Median: $23.99
1.9× median
99242Normal range

Office consultation, low complexity

$30K

486 claims · 0.1%

Your Cost: $61.43/claim|Median: $57.97
1.1× median
99231Normal range

Subsequent hospital care, per day, low complexity

$29K

1,392 claims · 0.1%

Your Cost: $20.92/claim|Median: $16.77
1.2× median
99217Top 25%

$26K

476 claims · 0.1%

Your Cost: $53.72/claim|Median: $31.89
1.7× median
59426Normal range

Antepartum care only, high risk, additional visits

$25K

86 claims · 0.1%

Your Cost: $289.84/claim|Median: $122.30
2.4× median
99219Top 25%

$20K

224 claims · 0.1%

Your Cost: $88.45/claim|Median: $63.35
1.4× median

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