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

⚖️ Compare🖨️ Print Report

Provider 1538245634

NPI: 1538245634Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$12.5M

$12,503,887

Total Claims

222K

Beneficiaries

175K

1.3 claims/patient

Avg Cost/Claim

$56

Monthly Spending Trend

Yearly Spending

2018
$1.6M
-14%
2019
$1.4M
-21%
2020
$1.1M
+72%
2021
$1.9M
+5%
2022
$2.0M
+29%
2023
$2.6M
-28%
2024
$1.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99284 (Emergency dept visit, high complexity)) accounts for 30% of total spending.

99284Top 5%

Emergency dept visit, high complexity

$3.7M

15K claims · 29.7%

Your Cost: $249.84/claim|Median: $69.51
3.6× median
99283Top 10%

Emergency dept visit, moderate complexity

$3.0M

17K claims · 24.3%

Your Cost: $180.66/claim|Median: $42.48
4.3× median
99285Top 10%

Emergency dept visit, high/urgent complexity

$1.0M

3,760 claims · 8.3%

Your Cost: $274.62/claim|Median: $85.65
3.2× median
92507Top 25%

Speech/hearing/language treatment

$813K

9,981 claims · 6.5%

Your Cost: $81.46/claim|Median: $49.45
1.6× median
97530Normal range

Therapeutic activities, each 15 min

$719K

18K claims · 5.8%

Your Cost: $40.54/claim|Median: $33.11
1.2× median
62323Top 5%

Epidural injection of diagnostic or therapeutic substance, lumbar

$702K

1,374 claims · 5.6%

Your Cost: $510.93/claim|Median: $111.02
4.6× median
G0463Normal range

Hospital outpatient clinic visit

$310K

16K claims · 2.5%

Your Cost: $19.85/claim|Median: $26.41
0.8× median
69436Top 25%

Tympanostomy, general anesthesia

$296K

464 claims · 2.4%

Your Cost: $638.03/claim|Median: $205.50
3.1× median
96361Top 25%

IV infusion, hydration, each additional hour

$277K

2,364 claims · 2.2%

Your Cost: $117.30/claim|Median: $38.92
3.0× median
97110Normal range

Therapeutic exercises, each 15 min

$239K

7,748 claims · 1.9%

Your Cost: $30.79/claim|Median: $24.49
1.3× median
20553Top 10%

$163K

1,754 claims · 1.3%

Your Cost: $92.82/claim|Median: $29.47
3.1× median
96374Normal range

Therapeutic/prophylactic/diagnostic IV push, single substance

$155K

7,469 claims · 1.2%

Your Cost: $20.75/claim|Median: $21.76
1.0× median
0241UTop 25%

Proprietary lab analysis, genomic sequencing

$113K

817 claims · 0.9%

Your Cost: $138.02/claim|Median: $91.47
1.5× median
G0378Normal range

Hospital observation service, per hour

$105K

398 claims · 0.8%

Your Cost: $264.06/claim|Median: $99.39
2.7× median
41899Normal range

Unlisted procedure, dentoalveolar structures

$96K

200 claims · 0.8%

Your Cost: $482.48/claim|Median: $763.43
0.6× median
45385Top 5%

Colonoscopy with polyp removal, snare technique

$83K

100 claims · 0.7%

Your Cost: $833.83/claim|Median: $255.17
3.3× median
43239Top 25%

Upper GI endoscopy with biopsy

$65K

160 claims · 0.5%

Your Cost: $407.61/claim|Median: $151.68
2.7× median
36415Top 25%

Collection of venous blood by venipuncture

$65K

23K claims · 0.5%

Your Cost: $2.81/claim|Median: $1.57
1.8× median
80307Top 25%

Drug test, presumptive, by chemistry analyzers

$47K

920 claims · 0.4%

Your Cost: $50.88/claim|Median: $35.43
1.4× median
97112Top 25%

Therapeutic procedure, neuromuscular reeducation, per 15 minutes

$45K

1,059 claims · 0.4%

Your Cost: $42.19/claim|Median: $20.04
2.1× median
96375Normal range

Therapeutic/prophylactic/diagnostic IV push, each additional substance

$44K

3,231 claims · 0.3%

Your Cost: $13.48/claim|Median: $14.92
0.9× median
74177Top 25%

CT abdomen and pelvis with contrast

$38K

232 claims · 0.3%

Your Cost: $163.86/claim|Median: $65.76
2.5× median
M0243Top 1%

$26K

52 claims · 0.2%

Your Cost: $491.06/claim|Median: $215.21
2.3× median
80053Normal range

Comprehensive metabolic panel

$21K

19K claims · 0.2%

Your Cost: $1.09/claim|Median: $7.24
0.2× median
96365Normal range

IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour

$21K

439 claims · 0.2%

Your Cost: $47.49/claim|Median: $54.77
0.9× median
96372Top 25%

Therapeutic injection, subcutaneous/intramuscular

$19K

1,200 claims · 0.2%

Your Cost: $15.85/claim|Median: $9.56
1.7× median
99282Normal range

Emergency dept visit, low complexity

$18K

316 claims · 0.1%

Your Cost: $55.75/claim|Median: $37.72
1.5× median
88305Normal range

Surgical pathology, gross and microscopic examination

$16K

1,393 claims · 0.1%

Your Cost: $11.23/claim|Median: $35.80
0.3× median
71046Normal range

Chest X-ray, 2 views

$13K

770 claims · 0.1%

Your Cost: $16.87/claim|Median: $8.92
1.9× median
J0585Normal range

Injection, onabotulinumtoxinA, 1 unit

$12K

52 claims · 0.1%

Your Cost: $234.72/claim|Median: $470.36
0.5× median
← All providersHow we detect fraud →