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Provider 1538215546

NPI: 1538215546Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$13.0M

$12,992,820

Total Claims

312K

Beneficiaries

268K

1.2 claims/patient

Avg Cost/Claim

$42

Monthly Spending Trend

Yearly Spending

2018
$1.6M
+11%
2019
$1.8M
+3%
2020
$1.8M
+35%
2021
$2.4M
-1%
2022
$2.4M
-22%
2023
$1.9M
-43%
2024
$1.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 25% of total spending.

99214Top 25%

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

$3.2M

41K claims · 24.8%

Your Cost: $78.40/claim|Median: $53.41
1.5× median
99213Normal range

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

$2.6M

48K claims · 19.7%

Your Cost: $53.22/claim|Median: $37.81
1.4× median
59426Normal range

Antepartum care only, high risk, additional visits

$1.1M

13K claims · 8.8%

Your Cost: $85.75/claim|Median: $122.30
0.7× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$981K

12K claims · 7.5%

Your Cost: $79.40/claim|Median: $69.35
1.1× median
99392Normal range

Preventive medicine, established patient, age 1-4

$738K

8,841 claims · 5.7%

Your Cost: $83.50/claim|Median: $75.18
1.1× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$734K

11K claims · 5.6%

Your Cost: $68.90/claim|Median: $58.55
1.2× median
59425Normal range

Antepartum care only, 4-6 visits

$659K

7,955 claims · 5.1%

Your Cost: $82.89/claim|Median: $63.63
1.3× median
90460Top 25%

Immunization administration, first vaccine/toxoid, with counseling

$648K

20K claims · 5.0%

Your Cost: $32.67/claim|Median: $17.85
1.8× median
87502Normal range

Influenza virus detection, reverse transcription, amplified probe

$366K

5,284 claims · 2.8%

Your Cost: $69.19/claim|Median: $65.64
1.1× median
59410Normal range

$205K

365 claims · 1.6%

Your Cost: $560.95/claim|Median: $781.64
0.7× median
87634Normal range

$175K

3,198 claims · 1.3%

Your Cost: $54.73/claim|Median: $48.78
1.1× median
87426Normal range

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

$167K

5,411 claims · 1.3%

Your Cost: $30.90/claim|Median: $30.04
1.0× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$155K

12K claims · 1.2%

Your Cost: $12.54/claim|Median: $11.48
1.1× median
99393Normal range

Preventive medicine, established patient, age 5-11

$110K

1,317 claims · 0.8%

Your Cost: $83.39/claim|Median: $74.82
1.1× median
96110Normal range

Developmental screening, per standardized instrument

$101K

13K claims · 0.8%

Your Cost: $7.69/claim|Median: $9.10
0.8× median
76805Normal range

Ultrasound, pregnant uterus, complete, single fetus

$94K

1,166 claims · 0.7%

Your Cost: $81.04/claim|Median: $74.78
1.1× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$93K

2,667 claims · 0.7%

Your Cost: $34.90/claim|Median: $57.30
0.6× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$81K

1,088 claims · 0.6%

Your Cost: $74.57/claim|Median: $62.48
1.2× median
99238Top 25%

Hospital discharge day management, 30 minutes or less

$68K

1,182 claims · 0.5%

Your Cost: $57.47/claim|Median: $37.22
1.5× median
D1206Normal range

Topical application of fluoride varnish

$60K

2,620 claims · 0.5%

Your Cost: $23.07/claim|Median: $18.12
1.3× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$52K

5,578 claims · 0.4%

Your Cost: $9.38/claim|Median: $9.56
1.0× median
87430Normal range

$47K

4,028 claims · 0.4%

Your Cost: $11.79/claim|Median: $9.41
1.3× median
87651Normal range

Streptococcus Group A detection, nucleic acid, amplified probe

$45K

2,050 claims · 0.3%

Your Cost: $21.98/claim|Median: $28.46
0.8× median
76819Normal range

Fetal biophysical profile with non-stress test

$43K

838 claims · 0.3%

Your Cost: $51.56/claim|Median: $49.45
1.0× median
87804Top 10%

Influenza virus detection, rapid test

$41K

1,536 claims · 0.3%

Your Cost: $26.93/claim|Median: $12.59
2.1× median
87811Normal range

SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-read

$39K

1,189 claims · 0.3%

Your Cost: $33.12/claim|Median: $30.53
1.1× median
99219Top 25%

$39K

426 claims · 0.3%

Your Cost: $90.67/claim|Median: $63.35
1.4× median
90461Normal range

Immunization admin, additional vaccine, counseling

$31K

14K claims · 0.2%

Your Cost: $2.25/claim|Median: $6.93
0.3× median
76830Normal range

Ultrasound, transvaginal

$28K

481 claims · 0.2%

Your Cost: $57.39/claim|Median: $57.47
1.0× median
99204Normal range

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

$22K

232 claims · 0.2%

Your Cost: $96.11/claim|Median: $84.03
1.1× median
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