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Provider 1568418531

NPI: 1568418531Share
Active Billing Period:2018-01→2024-12(78 months)

Total Paid

$8.5M

$8,464,397

Total Claims

216K

Beneficiaries

177K

1.2 claims/patient

Avg Cost/Claim

$39

Monthly Spending Trend

Yearly Spending

2018
$9K
-54%
2019
$4K
+28280%
2020
$1.1M
+47%
2021
$1.7M
+7%
2022
$1.8M
+8%
2023
$1.9M
+4%
2024
$2.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 27% of total spending.

99213Top 10%

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

$2.3M

28K claims · 26.7%

Your Cost: $80.71/claim|Median: $37.81
2.1× median
99214Top 10%

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

$2.2M

21K claims · 25.4%

Your Cost: $101.86/claim|Median: $53.41
1.9× median
99391Top 25%

Preventive medicine, established patient, infant (under 1)

$582K

6,711 claims · 6.9%

Your Cost: $86.73/claim|Median: $69.35
1.3× median
99392Top 25%

Preventive medicine, established patient, age 1-4

$577K

6,039 claims · 6.8%

Your Cost: $95.51/claim|Median: $75.18
1.3× median
99393Top 25%

Preventive medicine, established patient, age 5-11

$411K

4,249 claims · 4.9%

Your Cost: $96.70/claim|Median: $74.82
1.3× median
99394Top 25%

Preventive medicine, established patient, age 12-17

$333K

3,162 claims · 3.9%

Your Cost: $105.21/claim|Median: $80.15
1.3× median
87426Top 25%

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

$151K

3,953 claims · 1.8%

Your Cost: $38.19/claim|Median: $30.04
1.3× median
87428Normal range

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

$139K

3,260 claims · 1.6%

Your Cost: $42.63/claim|Median: $39.63
1.1× median
99204Top 25%

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

$136K

1,152 claims · 1.6%

Your Cost: $118.03/claim|Median: $84.03
1.4× median
87804Top 25%

Influenza virus detection, rapid test

$126K

6,194 claims · 1.5%

Your Cost: $20.33/claim|Median: $12.59
1.6× median
96110Normal range

Developmental screening, per standardized instrument

$113K

13K claims · 1.3%

Your Cost: $9.04/claim|Median: $9.10
1.0× median
90648Top 5%

$103K

5,331 claims · 1.2%

Your Cost: $19.37/claim|Median: $4.08
4.7× median
90677Top 25%

$95K

1,302 claims · 1.1%

Your Cost: $72.75/claim|Median: $12.96
5.6× median
92551Normal range

Screening audiometry, pure tone, air only

$91K

11K claims · 1.1%

Your Cost: $8.52/claim|Median: $6.61
1.3× median
90723Top 25%

DTaP-HepB-IPV vaccine

$81K

4,197 claims · 1.0%

Your Cost: $19.39/claim|Median: $5.78
3.4× median
99215Top 25%

Office/outpatient visit, high complexity

$81K

659 claims · 1.0%

Your Cost: $123.02/claim|Median: $74.09
1.7× median
90686Top 25%

Influenza virus vaccine, quadrivalent, preservative-free, IM

$80K

4,310 claims · 0.9%

Your Cost: $18.58/claim|Median: $7.18
2.6× median
90670Top 25%

$79K

4,190 claims · 0.9%

Your Cost: $18.84/claim|Median: $5.94
3.2× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$71K

17K claims · 0.8%

Your Cost: $4.17/claim|Median: $3.67
1.1× median
90680Top 10%

$69K

3,579 claims · 0.8%

Your Cost: $19.32/claim|Median: $5.58
3.5× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$63K

5,533 claims · 0.7%

Your Cost: $11.41/claim|Median: $11.48
1.0× median
99383Top 25%

Preventive visit, new patient, late childhood (5-11 yr)

$62K

558 claims · 0.7%

Your Cost: $110.24/claim|Median: $81.92
1.3× median
90633Top 10%

$57K

2,897 claims · 0.7%

Your Cost: $19.55/claim|Median: $3.56
5.5× median
90716Top 25%

$53K

2,672 claims · 0.6%

Your Cost: $19.87/claim|Median: $6.18
3.2× median
90707Top 25%

MMR vaccine

$52K

2,634 claims · 0.6%

Your Cost: $19.93/claim|Median: $5.76
3.5× median
90651Normal range

HPV vaccine, 9-valent

$36K

1,823 claims · 0.4%

Your Cost: $19.79/claim|Median: $8.93
2.2× median
83655Normal range

$33K

3,395 claims · 0.4%

Your Cost: $9.70/claim|Median: $10.49
0.9× median
90734Top 25%

$32K

1,683 claims · 0.4%

Your Cost: $19.31/claim|Median: $6.40
3.0× median
D1206Normal range

Topical application of fluoride varnish

$27K

2,000 claims · 0.3%

Your Cost: $13.30/claim|Median: $18.12
0.7× median
A4614Normal range

$26K

1,810 claims · 0.3%

Your Cost: $14.56/claim|Median: $14.20
1.0× median
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