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

⚖️ Compare🖨️ Print Report

Provider 1558420695

NPI: 1558420695Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$7.8M

$7,764,293

Total Claims

138K

Beneficiaries

128K

1.1 claims/patient

Avg Cost/Claim

$56

Monthly Spending Trend

Yearly Spending

2018
$1.6M
-30%
2019
$1.1M
-30%
2020
$772K
+19%
2021
$918K
+17%
2022
$1.1M
+21%
2023
$1.3M
-22%
2024
$1.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (J3490 (Unclassified drugs)) accounts for 11% of total spending.

J3490Top 25%

Unclassified drugs

$872K

16K claims · 11.2%

Your Cost: $52.87/claim|Median: $5.70
9.3× median
99213Top 5%

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

$780K

8,600 claims · 10.0%

Your Cost: $90.72/claim|Median: $37.81
2.4× median
S4993Top 25%

$766K

6,888 claims · 9.9%

Your Cost: $111.24/claim|Median: $46.61
2.4× median
J7307Top 25%

Etonogestrel implant system, including implant and supplies

$670K

633 claims · 8.6%

Your Cost: $1,059.17/claim|Median: $786.43
1.3× median
99214Top 5%

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

$529K

3,884 claims · 6.8%

Your Cost: $136.18/claim|Median: $53.41
2.5× median
99212Top 10%

Office/outpatient visit, low complexity

$482K

7,413 claims · 6.2%

Your Cost: $64.97/claim|Median: $25.06
2.6× median
99202Top 10%

Office/outpatient visit, new patient, low complexity

$449K

3,579 claims · 5.8%

Your Cost: $125.44/claim|Median: $40.11
3.1× median
87806Normal range

$405K

16K claims · 5.2%

Your Cost: $24.57/claim|Median: $20.54
1.2× median
S0199Normal range

$353K

698 claims · 4.5%

Your Cost: $505.57/claim|Median: $454.23
1.1× median
99203Top 5%

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

$332K

1,589 claims · 4.3%

Your Cost: $209.25/claim|Median: $57.85
3.6× median
99211Top 10%

Office/outpatient visit, minimal complexity

$326K

7,008 claims · 4.2%

Your Cost: $46.54/claim|Median: $12.93
3.6× median
99204Top 5%

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

$265K

1,170 claims · 3.4%

Your Cost: $226.22/claim|Median: $84.03
2.7× median
A4267Top 5%

$236K

9,944 claims · 3.0%

Your Cost: $23.73/claim|Median: $7.86
3.0× median
90651Top 5%

HPV vaccine, 9-valent

$218K

1,012 claims · 2.8%

Your Cost: $215.04/claim|Median: $8.93
24.1× median
11981Top 10%

$174K

638 claims · 2.2%

Your Cost: $272.37/claim|Median: $117.16
2.3× median
58300Top 25%

$149K

1,176 claims · 1.9%

Your Cost: $127.02/claim|Median: $74.77
1.7× median
99201Top 25%

Office/outpatient visit, new patient, straightforward

$143K

1,601 claims · 1.8%

Your Cost: $89.54/claim|Median: $27.38
3.3× median
J7298Normal range

$138K

164 claims · 1.8%

Your Cost: $841.66/claim|Median: $751.11
1.1× median
J7304Normal range

$127K

186 claims · 1.6%

Your Cost: $682.60/claim|Median: $630.59
1.1× median
81025Normal range

Urine pregnancy test

$65K

12K claims · 0.8%

Your Cost: $5.30/claim|Median: $4.81
1.1× median
11976Normal range

$55K

841 claims · 0.7%

Your Cost: $65.14/claim|Median: $57.06
1.1× median
S0190Normal range

$40K

676 claims · 0.5%

Your Cost: $59.23/claim|Median: $58.42
1.0× median
S5199Normal range

Personal care item, NOS, each

$35K

8,089 claims · 0.5%

Your Cost: $4.35/claim|Median: $10.82
0.4× median
S9445Normal range

$25K

1,982 claims · 0.3%

Your Cost: $12.71/claim|Median: $12.72
1.0× median
J7303Top 25%

$22K

74 claims · 0.3%

Your Cost: $304.02/claim|Median: $125.58
2.4× median
99000Normal range

$22K

7,295 claims · 0.3%

Your Cost: $2.99/claim|Median: $2.30
1.3× median
83986Normal range

$15K

5,402 claims · 0.2%

Your Cost: $2.84/claim|Median: $2.70
1.1× median
S5000Normal range

Prescription drug, generic

$14K

2,280 claims · 0.2%

Your Cost: $6.33/claim|Median: $7.47
0.8× median
58301Normal range

$14K

338 claims · 0.2%

Your Cost: $42.06/claim|Median: $49.65
0.8× median
Q0111Normal range

$10K

2,675 claims · 0.1%

Your Cost: $3.57/claim|Median: $3.66
1.0× median
← All providersHow we detect fraud →