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Provider 1538582945

NPI: 1538582945Share
Active Billing Period:2018-01→2023-04(64 months)
Billing appears to have stoppedLast active: 2023-04

Total Paid

$15.8M

$15,780,046

Total Claims

303K

Beneficiaries

245K

1.2 claims/patient

Avg Cost/Claim

$52

Monthly Spending Trend

Yearly Spending

2018
$1.4M
-40%
2019
$825K
+331%
2020
$3.6M
+16%
2021
$4.1M
+15%
2022
$4.7M
-75%
2023
$1.2M

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 29% of total spending.

99214Top 25%

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

$4.5M

50K claims · 28.8%

Your Cost: $90.92/claim|Median: $53.41
1.7× median
99213Top 25%

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

$4.0M

60K claims · 25.4%

Your Cost: $66.80/claim|Median: $37.81
1.8× median
99215Normal range

Office/outpatient visit, high complexity

$670K

7,588 claims · 4.2%

Your Cost: $88.36/claim|Median: $74.09
1.2× median
99232Top 25%

Subsequent hospital care, per day, moderate complexity

$653K

17K claims · 4.1%

Your Cost: $38.36/claim|Median: $23.99
1.6× median
99391Top 25%

Preventive medicine, established patient, infant (under 1)

$461K

5,360 claims · 2.9%

Your Cost: $85.95/claim|Median: $69.35
1.2× median
99392Top 25%

Preventive medicine, established patient, age 1-4

$418K

4,196 claims · 2.6%

Your Cost: $99.55/claim|Median: $75.18
1.3× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$385K

11K claims · 2.4%

Your Cost: $35.00/claim|Median: $58.55
0.6× median
76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$277K

3,265 claims · 1.8%

Your Cost: $84.75/claim|Median: $106.79
0.8× median
99393Top 25%

Preventive medicine, established patient, age 5-11

$265K

2,652 claims · 1.7%

Your Cost: $99.77/claim|Median: $74.82
1.3× median
59025Normal range

Fetal non-stress test

$229K

9,592 claims · 1.5%

Your Cost: $23.85/claim|Median: $26.45
0.9× median
99460Normal range

Initial hospital or birthing center care, newborn, per day

$220K

3,057 claims · 1.4%

Your Cost: $71.95/claim|Median: $62.48
1.2× median
99238Top 25%

Hospital discharge day management, 30 minutes or less

$193K

3,770 claims · 1.2%

Your Cost: $51.17/claim|Median: $37.22
1.4× median
99395Top 25%

Preventive medicine, established patient, age 18-39

$183K

1,719 claims · 1.2%

Your Cost: $106.58/claim|Median: $72.71
1.5× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$180K

2,933 claims · 1.1%

Your Cost: $61.27/claim|Median: $43.85
1.4× median
99223Normal range

Initial hospital care, per day, high complexity

$168K

2,701 claims · 1.1%

Your Cost: $62.12/claim|Median: $67.32
0.9× median
99233Normal range

Subsequent hospital care, per day, high complexity

$163K

3,182 claims · 1.0%

Your Cost: $51.34/claim|Median: $35.30
1.5× median
99283Normal range

Emergency dept visit, moderate complexity

$152K

2,598 claims · 1.0%

Your Cost: $58.58/claim|Median: $42.48
1.4× median
99222Normal range

Initial hospital care, per day, moderate complexity

$141K

2,784 claims · 0.9%

Your Cost: $50.55/claim|Median: $51.25
1.0× median
90686Top 10%

Influenza virus vaccine, quadrivalent, preservative-free, IM

$140K

6,633 claims · 0.9%

Your Cost: $21.09/claim|Median: $7.18
2.9× median
99394Top 25%

Preventive medicine, established patient, age 12-17

$136K

1,258 claims · 0.9%

Your Cost: $108.23/claim|Median: $80.15
1.4× median
87426Top 25%

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

$123K

3,065 claims · 0.8%

Your Cost: $40.23/claim|Median: $30.04
1.3× median
99204Normal range

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

$115K

1,168 claims · 0.7%

Your Cost: $98.60/claim|Median: $84.03
1.2× median
99212Normal range

Office/outpatient visit, low complexity

$109K

3,075 claims · 0.7%

Your Cost: $35.44/claim|Median: $25.06
1.4× median
76818Normal range

$99K

2,584 claims · 0.6%

Your Cost: $38.31/claim|Median: $68.15
0.6× median
99220Normal range

$97K

1,041 claims · 0.6%

Your Cost: $93.55/claim|Median: $73.56
1.3× median
99284Top 25%

Emergency dept visit, high complexity

$88K

869 claims · 0.6%

Your Cost: $100.76/claim|Median: $69.51
1.4× median
76819Normal range

Fetal biophysical profile with non-stress test

$82K

2,723 claims · 0.5%

Your Cost: $30.14/claim|Median: $49.45
0.6× median
99219Normal range

$74K

1,023 claims · 0.5%

Your Cost: $72.57/claim|Median: $63.35
1.1× median
76801Normal range

Ultrasound, pregnant uterus, single fetus, first trimester

$69K

1,560 claims · 0.4%

Your Cost: $44.37/claim|Median: $58.16
0.8× median
99469Normal range

Subsequent intensive care, very low birth weight infant

$69K

248 claims · 0.4%

Your Cost: $278.59/claim|Median: $293.45
0.9× median
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