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Provider 1538214713

NPI: 1538214713Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$9.2M

$9,181,617

Total Claims

288K

Beneficiaries

265K

1.1 claims/patient

Avg Cost/Claim

$32

Monthly Spending Trend

Yearly Spending

2018
$701K
+108%
2019
$1.5M
-10%
2020
$1.3M
+4%
2021
$1.4M
+7%
2022
$1.5M
+7%
2023
$1.6M
-16%
2024
$1.3M

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 38% of total spending.

99213Top 25%

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

$3.5M

56K claims · 38.4%

Your Cost: $62.70/claim|Median: $37.81
1.7× median
99392Normal range

Preventive medicine, established patient, age 1-4

$1.3M

16K claims · 14.5%

Your Cost: $82.33/claim|Median: $75.18
1.1× median
99214Top 25%

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

$1.1M

12K claims · 11.7%

Your Cost: $90.79/claim|Median: $53.41
1.7× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$1.0M

13K claims · 11.1%

Your Cost: $78.28/claim|Median: $69.35
1.1× median
99393Normal range

Preventive medicine, established patient, age 5-11

$795K

9,891 claims · 8.7%

Your Cost: $80.43/claim|Median: $74.82
1.1× median
99394Normal range

Preventive medicine, established patient, age 12-17

$252K

2,862 claims · 2.7%

Your Cost: $87.98/claim|Median: $80.15
1.1× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$227K

19K claims · 2.5%

Your Cost: $12.19/claim|Median: $7.18
1.7× median
90670Top 25%

$112K

5,572 claims · 1.2%

Your Cost: $20.08/claim|Median: $5.94
3.4× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$94K

18K claims · 1.0%

Your Cost: $5.22/claim|Median: $3.67
1.4× median
99199Normal range

Unlisted special service, procedure, or report

$62K

10K claims · 0.7%

Your Cost: $6.08/claim|Median: $5.39
1.1× median
87428Normal range

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

$57K

1,548 claims · 0.6%

Your Cost: $36.86/claim|Median: $39.63
0.9× median
96160Normal range

Patient-focused health risk assessment

$53K

22K claims · 0.6%

Your Cost: $2.45/claim|Median: $2.10
1.2× median
87880Top 25%

Streptococcus, Group A, rapid antigen detection

$49K

3,314 claims · 0.5%

Your Cost: $14.66/claim|Median: $11.48
1.3× median
96110Normal range

Developmental screening, per standardized instrument

$48K

5,252 claims · 0.5%

Your Cost: $9.05/claim|Median: $9.10
1.0× median
92551Top 25%

Screening audiometry, pure tone, air only

$47K

4,504 claims · 0.5%

Your Cost: $10.37/claim|Median: $6.61
1.6× median
90651Top 25%

HPV vaccine, 9-valent

$42K

1,211 claims · 0.5%

Your Cost: $34.46/claim|Median: $8.93
3.9× median
90698Top 25%

$40K

2,579 claims · 0.4%

Your Cost: $15.44/claim|Median: $6.32
2.4× median
99212Normal range

Office/outpatient visit, low complexity

$40K

1,113 claims · 0.4%

Your Cost: $35.55/claim|Median: $25.06
1.4× median
96161Normal range

$31K

13K claims · 0.3%

Your Cost: $2.42/claim|Median: $2.49
1.0× median
90677Normal range

$26K

745 claims · 0.3%

Your Cost: $35.08/claim|Median: $12.96
2.7× median
90680Top 25%

$24K

1,547 claims · 0.3%

Your Cost: $15.76/claim|Median: $5.58
2.8× median
90656Top 25%

$24K

1,225 claims · 0.3%

Your Cost: $19.41/claim|Median: $8.67
2.2× median
87804Normal range

Influenza virus detection, rapid test

$23K

1,562 claims · 0.3%

Your Cost: $14.78/claim|Median: $12.59
1.2× median
99174Normal range

$20K

3,594 claims · 0.2%

Your Cost: $5.49/claim|Median: $5.27
1.0× median
90671Top 25%

$17K

646 claims · 0.2%

Your Cost: $25.82/claim|Median: $8.59
3.0× median
80061Top 25%

Lipid panel

$16K

1,170 claims · 0.2%

Your Cost: $13.76/claim|Median: $8.41
1.6× median
90633Top 25%

$14K

1,125 claims · 0.2%

Your Cost: $12.70/claim|Median: $3.56
3.6× median
85018Top 25%

$14K

5,483 claims · 0.2%

Your Cost: $2.52/claim|Median: $1.71
1.5× median
90697Top 25%

$13K

630 claims · 0.1%

Your Cost: $21.23/claim|Median: $7.24
2.9× median
1128FNormal range

$12K

28K claims · 0.1%

Your Cost: $0.41/claim|Median: $0.38
1.1× median
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