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

⚖️ Compare🖨️ Print Report

BAYSTATE MEDICAL PRACTICES, INC

Emergency Medicine, Emergency Medical Services·SPRINGFIELD, MA·NPI: 1548205909Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$60.5M

$60,506,534

Total Claims

1.6M

Beneficiaries

1.4M

1.1 claims/patient

Avg Cost/Claim

$38

Monthly Spending Trend

Yearly Spending

2018
$9.5M
-6%
2019
$8.9M
-20%
2020
$7.1M
+28%
2021
$9.1M
+8%
2022
$9.9M
-13%
2023
$8.6M
-13%
2024
$7.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 20% of total spending.

99214Normal range

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

$11.9M

254K claims · 19.7%

Your Cost: $47.02/claim|Median: $53.41
0.9× median
99285Normal range

Emergency dept visit, high/urgent complexity

$8.3M

109K claims · 13.7%

Your Cost: $75.77/claim|Median: $85.65
0.9× median
99284Normal range

Emergency dept visit, high complexity

$7.1M

96K claims · 11.7%

Your Cost: $73.92/claim|Median: $69.51
1.1× median
99213Normal range

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

$5.9M

156K claims · 9.7%

Your Cost: $37.45/claim|Median: $37.81
1.0× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$3.4M

145K claims · 5.6%

Your Cost: $23.45/claim|Median: $23.99
1.0× median
99233Normal range

Subsequent hospital care, per day, high complexity

$2.9M

93K claims · 4.9%

Your Cost: $31.66/claim|Median: $35.30
0.9× median
99223Normal range

Initial hospital care, per day, high complexity

$2.2M

33K claims · 3.6%

Your Cost: $65.02/claim|Median: $67.32
1.0× median
88305Normal range

Surgical pathology, gross and microscopic examination

$1.3M

39K claims · 2.2%

Your Cost: $34.02/claim|Median: $35.80
1.0× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$993K

30K claims · 1.6%

Your Cost: $33.36/claim|Median: $43.85
0.8× median
99283Normal range

Emergency dept visit, moderate complexity

$980K

21K claims · 1.6%

Your Cost: $47.54/claim|Median: $42.48
1.1× median
93010Normal range

Electrocardiogram, interpretation and report only

$956K

254K claims · 1.6%

Your Cost: $3.76/claim|Median: $5.60
0.7× median
99215Normal range

Office/outpatient visit, high complexity

$909K

14K claims · 1.5%

Your Cost: $62.90/claim|Median: $74.09
0.8× median
99291Normal range

Critical care, first 30-74 minutes

$859K

11K claims · 1.4%

Your Cost: $77.65/claim|Median: $101.24
0.8× median
99204Normal range

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

$793K

9,161 claims · 1.3%

Your Cost: $86.52/claim|Median: $84.03
1.0× median
93306Normal range

Echocardiography, transthoracic, complete, with Doppler

$754K

28K claims · 1.2%

Your Cost: $26.88/claim|Median: $54.68
0.5× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$632K

14K claims · 1.0%

Your Cost: $44.66/claim|Median: $37.22
1.2× median
99222Normal range

Initial hospital care, per day, moderate complexity

$566K

11K claims · 0.9%

Your Cost: $50.40/claim|Median: $51.25
1.0× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$540K

14K claims · 0.9%

Your Cost: $37.74/claim|Median: $58.55
0.6× median
76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$528K

7,404 claims · 0.9%

Your Cost: $71.25/claim|Median: $106.79
0.7× median
99479Normal range

Subsequent intensive care, 2,501-5,000 grams

$491K

5,315 claims · 0.8%

Your Cost: $92.45/claim|Median: $103.70
0.9× median
99460Top 10%

Initial hospital or birthing center care, newborn, per day

$458K

4,675 claims · 0.8%

Your Cost: $97.88/claim|Median: $62.48
1.6× median
76819Normal range

Fetal biophysical profile with non-stress test

$456K

15K claims · 0.8%

Your Cost: $31.04/claim|Median: $49.45
0.6× median
99469Normal range

Subsequent intensive care, very low birth weight infant

$432K

1,507 claims · 0.7%

Your Cost: $286.65/claim|Median: $293.45
1.0× median
90834Top 25%

Psychotherapy, 45 minutes

$394K

4,490 claims · 0.7%

Your Cost: $87.78/claim|Median: $63.65
1.4× median
99255Top 5%

$374K

1,431 claims · 0.6%

Your Cost: $261.67/claim|Median: $90.45
2.9× median
99203Normal range

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

$338K

5,399 claims · 0.6%

Your Cost: $62.58/claim|Median: $57.85
1.1× median
90791Top 25%

Psychiatric diagnostic evaluation

$288K

2,135 claims · 0.5%

Your Cost: $134.68/claim|Median: $99.21
1.4× median
99480Normal range

Subsequent intensive care, very low birth weight infant

$278K

3,194 claims · 0.5%

Your Cost: $86.92/claim|Median: $98.15
0.9× median
76801Normal range

Ultrasound, pregnant uterus, single fetus, first trimester

$251K

5,777 claims · 0.4%

Your Cost: $43.50/claim|Median: $58.16
0.7× median
90887Top 25%

Interpretation/explanation of results

$246K

2,374 claims · 0.4%

Your Cost: $103.59/claim|Median: $47.55
2.2× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$242K

1,841 claims · 0.4%

Your Cost: $131.71/claim|Median: $111.09
1.2× median
99393Normal range

Preventive medicine, established patient, age 5-11

$242K

2,756 claims · 0.4%

Your Cost: $87.65/claim|Median: $74.82
1.2× median
S0302Normal range

$200K

21K claims · 0.3%

Your Cost: $9.41/claim|Median: $9.05
1.0× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$197K

1,781 claims · 0.3%

Your Cost: $110.82/claim|Median: $108.91
1.0× median
90471Top 25%

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

$197K

12K claims · 0.3%

Your Cost: $17.01/claim|Median: $9.80
1.7× median
76817Normal range

Ultrasound, pregnant uterus, transvaginal

$183K

5,862 claims · 0.3%

Your Cost: $31.19/claim|Median: $47.65
0.7× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$161K

2,012 claims · 0.3%

Your Cost: $80.08/claim|Median: $69.35
1.2× median
99392Normal range

Preventive medicine, established patient, age 1-4

$159K

1,808 claims · 0.3%

Your Cost: $88.03/claim|Median: $75.18
1.2× median
96110Normal range

Developmental screening, per standardized instrument

$152K

15K claims · 0.3%

Your Cost: $10.34/claim|Median: $9.10
1.1× median
88307Normal range

Surgical pathology, gross and microscopic, complex

$142K

2,500 claims · 0.2%

Your Cost: $56.96/claim|Median: $59.38
1.0× median
90837Normal range

Psychotherapy, 60 minutes

$125K

1,309 claims · 0.2%

Your Cost: $95.42/claim|Median: $85.66
1.1× median
88141Top 25%

$124K

5,750 claims · 0.2%

Your Cost: $21.56/claim|Median: $14.87
1.4× median
99394Top 25%

Preventive medicine, established patient, age 12-17

$117K

1,218 claims · 0.2%

Your Cost: $96.05/claim|Median: $80.15
1.2× median
99443Normal range

Telephone E/M by physician, 21-30 min

$116K

7,179 claims · 0.2%

Your Cost: $16.18/claim|Median: $32.55
0.5× median
99220Normal range

$113K

1,841 claims · 0.2%

Your Cost: $61.27/claim|Median: $73.56
0.8× median
76813Normal range

Ultrasound for fetal nuchal translucency measurement

$111K

2,357 claims · 0.2%

Your Cost: $47.29/claim|Median: $70.87
0.7× median
90460Top 25%

Immunization administration, first vaccine/toxoid, with counseling

$101K

3,270 claims · 0.2%

Your Cost: $30.89/claim|Median: $17.85
1.7× median
59025Normal range

Fetal non-stress test

$100K

3,473 claims · 0.2%

Your Cost: $28.91/claim|Median: $26.45
1.1× median
43239Normal range

Upper GI endoscopy with biopsy

$94K

2,095 claims · 0.2%

Your Cost: $45.03/claim|Median: $151.68
0.3× median
99212Normal range

Office/outpatient visit, low complexity

$91K

4,687 claims · 0.2%

Your Cost: $19.42/claim|Median: $25.06
0.8× median

Other Top Providers in Massachusetts

View all →

Tempus Unlimited, Inc.

Voluntary or Charitable

$5.57B

Department of Developmental Services

Case Management

$1.35B

Commonwealth of Massachusets

Case Management

$1.14B

Commonwealth of Mass-dds

Case Management

$1.10B

Stavros Center for Independent Living Inc.

Case Management

$1.04B

← All providersAll providers in Massachusetts →How we detect fraud →