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Provider 1609851039

NPI: 1609851039Share
Active Billing Period:2018-012024-09(81 months)

Total Paid

$10.0M

$9,978,121

Total Claims

25K

Beneficiaries

21K

1.2 claims/patient

Avg Cost/Claim

$392

Monthly Spending Trend

Yearly Spending

2018
$1.7M
-24%
2019
$1.3M
-7%
2020
$1.2M
+30%
2021
$1.6M
-1%
2022
$1.6M
+3%
2023
$1.6M
-42%
2024
$938K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 60% of total spending.

99213Top 1%

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

$6.0M

13K claims · 60.0%

Your Cost: $447.32/claim|Median: $37.81
11.8× median
99283Top 1%

Emergency dept visit, moderate complexity

$2.7M

6,094 claims · 27.1%

Your Cost: $443.55/claim|Median: $42.48
10.4× median
92012Top 1%

Ophthalmological exam, intermediate, established patient

$348K

1,097 claims · 3.5%

Your Cost: $317.67/claim|Median: $38.23
8.3× median
42700Normal range

$263K

1,238 claims · 2.6%

Your Cost: $212.24/claim|Median: $361.34
0.6× median
45500Normal range

$218K

1,005 claims · 2.2%

Your Cost: $216.73/claim|Median: $306.59
0.7× median
51900Normal range

$194K

1,315 claims · 1.9%

Your Cost: $147.71/claim|Median: $277.53
0.5× median
47900Normal range

$172K

732 claims · 1.7%

Your Cost: $235.51/claim|Median: $235.51
1.0× median
90837Top 1%

Psychotherapy, 60 minutes

$53K

127 claims · 0.5%

Your Cost: $413.55/claim|Median: $85.66
4.8× median
D1206Top 1%

Topical application of fluoride varnish

$22K

69 claims · 0.2%

Your Cost: $321.80/claim|Median: $18.12
17.8× median
99211Top 10%

Office/outpatient visit, minimal complexity

$13K

214 claims · 0.1%

Your Cost: $62.28/claim|Median: $12.93
4.8× median
W0037Normal range

$423

141 claims · 0.0%

Your Cost: $3.00/claim|Median: $3.00
1.0× median
92002Normal range

Intermediate eye exam, new patient

$0

12 claims · 0.0%

Your Cost: $0.00/claim|Median: $41.61