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Provider 1538568928

NPI: 1538568928Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$10.9M

$10,882,520

Total Claims

320K

Beneficiaries

295K

1.1 claims/patient

Avg Cost/Claim

$34

Monthly Spending Trend

Yearly Spending

2018
$647K
+312%
2019
$2.7M
-42%
2020
$1.5M
+78%
2021
$2.7M
-22%
2022
$2.1M
-67%
2023
$707K
-34%
2024
$464K

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 31% of total spending.

99214Normal range

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

$3.4M

54K claims · 31.1%

Your Cost: $63.26/claim|Median: $53.41
1.2× median
99213Normal range

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

$1.8M

40K claims · 16.9%

Your Cost: $45.79/claim|Median: $37.81
1.2× median
99215Normal range

Office/outpatient visit, high complexity

$1.0M

10K claims · 9.4%

Your Cost: $99.04/claim|Median: $74.09
1.3× median
S0302Top 10%

$720K

20K claims · 6.6%

Your Cost: $36.87/claim|Median: $9.05
4.1× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$370K

18K claims · 3.4%

Your Cost: $20.97/claim|Median: $17.85
1.2× median
X5622Normal range

$366K

11K claims · 3.4%

Your Cost: $34.32/claim|Median: $52.61
0.7× median
99392Normal range

Preventive medicine, established patient, age 1-4

$359K

6,087 claims · 3.3%

Your Cost: $58.93/claim|Median: $75.18
0.8× median
99309Top 10%

Nursing facility care, subsequent, low complexity

$337K

8,280 claims · 3.1%

Your Cost: $40.66/claim|Median: $14.00
2.9× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$301K

5,973 claims · 2.8%

Your Cost: $50.32/claim|Median: $69.35
0.7× median
99393Normal range

Preventive medicine, established patient, age 5-11

$235K

3,730 claims · 2.2%

Your Cost: $62.90/claim|Median: $74.82
0.8× median
90471Normal range

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

$185K

15K claims · 1.7%

Your Cost: $12.59/claim|Median: $9.80
1.3× median
99310Top 10%

$147K

2,067 claims · 1.3%

Your Cost: $71.01/claim|Median: $21.82
3.3× median
99394Normal range

Preventive medicine, established patient, age 12-17

$137K

1,949 claims · 1.3%

Your Cost: $70.36/claim|Median: $80.15
0.9× median
99308Top 10%

Nursing facility care, subsequent, straightforward

$133K

4,592 claims · 1.2%

Your Cost: $28.96/claim|Median: $9.79
3.0× median
90750Normal range

$110K

847 claims · 1.0%

Your Cost: $129.66/claim|Median: $96.16
1.3× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$88K

15K claims · 0.8%

Your Cost: $5.81/claim|Median: $7.18
0.8× median
91322Normal range

$80K

737 claims · 0.7%

Your Cost: $108.75/claim|Median: $76.28
1.4× median
99203Normal range

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

$79K

1,253 claims · 0.7%

Your Cost: $63.26/claim|Median: $57.85
1.1× median
90834Normal range

Psychotherapy, 45 minutes

$77K

1,292 claims · 0.7%

Your Cost: $59.28/claim|Median: $63.65
0.9× median
90651Top 25%

HPV vaccine, 9-valent

$61K

2,654 claims · 0.6%

Your Cost: $22.87/claim|Median: $8.93
2.6× median
99212Normal range

Office/outpatient visit, low complexity

$48K

1,636 claims · 0.4%

Your Cost: $29.04/claim|Median: $25.06
1.2× median
90670Normal range

$43K

4,771 claims · 0.4%

Your Cost: $8.91/claim|Median: $5.94
1.5× median
T1013Normal range

Sign language or oral interpretive services, per 15 minutes

$40K

1,411 claims · 0.4%

Your Cost: $28.58/claim|Median: $17.67
1.6× median
90662Top 25%

$38K

834 claims · 0.3%

Your Cost: $45.03/claim|Median: $6.55
6.9× median
99188Normal range

$34K

2,926 claims · 0.3%

Your Cost: $11.50/claim|Median: $12.80
0.9× median
99211Normal range

Office/outpatient visit, minimal complexity

$33K

2,973 claims · 0.3%

Your Cost: $11.21/claim|Median: $12.93
0.9× median
90791Normal range

Psychiatric diagnostic evaluation

$32K

303 claims · 0.3%

Your Cost: $105.08/claim|Median: $99.21
1.1× median
99442Normal range

Telephone E/M by physician, 11-20 minutes

$31K

740 claims · 0.3%

Your Cost: $41.29/claim|Median: $22.44
1.8× median
90480Normal range

$30K

999 claims · 0.3%

Your Cost: $29.75/claim|Median: $25.29
1.2× median
99443Normal range

Telephone E/M by physician, 21-30 min

$30K

511 claims · 0.3%

Your Cost: $57.78/claim|Median: $32.55
1.8× median
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