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

⚖️ Compare🖨️ Print Report

Provider 1538597349

NPI: 1538597349Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$9.6M

$9,579,436

Total Claims

279K

Beneficiaries

249K

1.1 claims/patient

Avg Cost/Claim

$34

Monthly Spending Trend

Yearly Spending

2018
$985K
+20%
2019
$1.2M
-13%
2020
$1.0M
+58%
2021
$1.6M
+1%
2022
$1.6M
+6%
2023
$1.7M
-21%
2024
$1.4M

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.

99214Normal range

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

$2.4M

34K claims · 25.2%

Your Cost: $70.36/claim|Median: $53.41
1.3× median
99213Top 25%

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

$2.3M

41K claims · 24.0%

Your Cost: $56.07/claim|Median: $37.81
1.5× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$647K

9,748 claims · 6.8%

Your Cost: $66.40/claim|Median: $69.35
1.0× median
99392Normal range

Preventive medicine, established patient, age 1-4

$523K

8,122 claims · 5.5%

Your Cost: $64.39/claim|Median: $75.18
0.9× median
99284Normal range

Emergency dept visit, high complexity

$353K

7,779 claims · 3.7%

Your Cost: $45.35/claim|Median: $69.51
0.7× median
99283Normal range

Emergency dept visit, moderate complexity

$331K

11K claims · 3.5%

Your Cost: $28.85/claim|Median: $42.48
0.7× median
99285Normal range

Emergency dept visit, high/urgent complexity

$234K

4,221 claims · 2.4%

Your Cost: $55.43/claim|Median: $85.65
0.6× median
99460Top 25%

Initial hospital or birthing center care, newborn, per day

$234K

2,759 claims · 2.4%

Your Cost: $84.80/claim|Median: $62.48
1.4× median
99393Normal range

Preventive medicine, established patient, age 5-11

$212K

3,480 claims · 2.2%

Your Cost: $60.97/claim|Median: $74.82
0.8× median
99238Top 10%

Hospital discharge day management, 30 minutes or less

$191K

3,029 claims · 2.0%

Your Cost: $63.03/claim|Median: $37.22
1.7× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$187K

8,593 claims · 1.9%

Your Cost: $21.73/claim|Median: $23.99
0.9× median
87428Normal range

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

$150K

3,104 claims · 1.6%

Your Cost: $48.21/claim|Median: $39.63
1.2× median
90670Top 25%

$116K

6,042 claims · 1.2%

Your Cost: $19.23/claim|Median: $5.94
3.2× median
99223Normal range

Initial hospital care, per day, high complexity

$110K

1,702 claims · 1.1%

Your Cost: $64.55/claim|Median: $67.32
1.0× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$104K

8,021 claims · 1.1%

Your Cost: $12.91/claim|Median: $11.48
1.1× median
90723Top 25%

DTaP-HepB-IPV vaccine

$96K

5,096 claims · 1.0%

Your Cost: $18.84/claim|Median: $5.78
3.3× median
90647Top 10%

$89K

4,752 claims · 0.9%

Your Cost: $18.78/claim|Median: $4.31
4.4× median
99308Top 25%

Nursing facility care, subsequent, straightforward

$82K

4,620 claims · 0.9%

Your Cost: $17.79/claim|Median: $9.79
1.8× median
54150Top 25%

$78K

515 claims · 0.8%

Your Cost: $150.79/claim|Median: $84.60
1.8× median
99394Normal range

Preventive medicine, established patient, age 12-17

$72K

1,219 claims · 0.7%

Your Cost: $58.79/claim|Median: $80.15
0.7× median
93010Normal range

Electrocardiogram, interpretation and report only

$67K

19K claims · 0.7%

Your Cost: $3.51/claim|Median: $5.60
0.6× median
90460Top 1%

Immunization administration, first vaccine/toxoid, with counseling

$66K

1,114 claims · 0.7%

Your Cost: $59.30/claim|Median: $17.85
3.3× median
99215Normal range

Office/outpatient visit, high complexity

$64K

877 claims · 0.7%

Your Cost: $73.51/claim|Median: $74.09
1.0× median
90686Top 10%

Influenza virus vaccine, quadrivalent, preservative-free, IM

$61K

3,260 claims · 0.6%

Your Cost: $18.80/claim|Median: $7.18
2.6× median
96110Normal range

Developmental screening, per standardized instrument

$59K

4,288 claims · 0.6%

Your Cost: $13.83/claim|Median: $9.10
1.5× median
90681Top 10%

$46K

2,451 claims · 0.5%

Your Cost: $18.90/claim|Median: $5.74
3.3× median
99282Normal range

Emergency dept visit, low complexity

$45K

3,101 claims · 0.5%

Your Cost: $14.60/claim|Median: $37.72
0.4× median
87804Top 25%

Influenza virus detection, rapid test

$45K

2,202 claims · 0.5%

Your Cost: $20.40/claim|Median: $12.59
1.6× median
99461Top 25%

$41K

460 claims · 0.4%

Your Cost: $88.47/claim|Median: $74.20
1.2× median
D1206Normal range

Topical application of fluoride varnish

$40K

1,932 claims · 0.4%

Your Cost: $20.93/claim|Median: $18.12
1.2× median
← All providersHow we detect fraud →