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Provider 1639414139

NPI: 1639414139Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$15.0M

$14,995,459

Total Claims

191K

Beneficiaries

161K

1.2 claims/patient

Avg Cost/Claim

$79

Monthly Spending Trend

Yearly Spending

2018
$1.8M
-26%
2019
$1.4M
+45%
2020
$2.0M
+15%
2021
$2.3M
-6%
2022
$2.1M
+27%
2023
$2.7M
-3%
2024
$2.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 78% of total spending.

T1015Top 25%

Clinic visit/encounter, all-inclusive

$11.7M

50K claims · 78.1%

Your Cost: $233.15/claim|Median: $121.16
1.9× median
00003Top 25%

Anesthesia services

$3.0M

9,944 claims · 19.8%

Your Cost: $297.92/claim|Median: $223.77
1.3× median
90834Normal range

Psychotherapy, 45 minutes

$229K

6,326 claims · 1.5%

Your Cost: $36.18/claim|Median: $63.65
0.6× median
90832Normal range

Psychotherapy, 30 minutes

$51K

2,326 claims · 0.3%

Your Cost: $22.00/claim|Median: $41.28
0.5× median
90837Normal range

Psychotherapy, 60 minutes

$14K

175 claims · 0.1%

Your Cost: $80.06/claim|Median: $85.66
0.9× median
90688Normal range

$5K

1,166 claims · 0.0%

Your Cost: $4.00/claim|Median: $9.00
0.4× median
99214Normal range

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

$4K

24K claims · 0.0%

Your Cost: $0.17/claim|Median: $53.41
0.0× median
90791Normal range

Psychiatric diagnostic evaluation

$4K

65 claims · 0.0%

Your Cost: $53.90/claim|Median: $99.21
0.5× median
99213Normal range

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

$3K

28K claims · 0.0%

Your Cost: $0.11/claim|Median: $37.81
0.0× median
99215Normal range

Office/outpatient visit, high complexity

$2K

5,140 claims · 0.0%

Your Cost: $0.29/claim|Median: $74.09
0.0× median
90471Normal range

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

$529

7,141 claims · 0.0%

Your Cost: $0.07/claim|Median: $9.80
0.0× median
G0467Normal range

Federally qualified health center visit, mental health

$489

16 claims · 0.0%

Your Cost: $30.54/claim|Median: $21.91
1.4× median
99211Normal range

Office/outpatient visit, minimal complexity

$446

633 claims · 0.0%

Your Cost: $0.71/claim|Median: $12.93
0.1× median
3008FNormal range

$368

20K claims · 0.0%

Your Cost: $0.02/claim|Median: $0.06
0.3× median
99212Normal range

Office/outpatient visit, low complexity

$329

11K claims · 0.0%

Your Cost: $0.03/claim|Median: $25.06
0.0× median
99204Normal range

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

$273

333 claims · 0.0%

Your Cost: $0.82/claim|Median: $84.03
0.0× median
86704Normal range

$214

174 claims · 0.0%

Your Cost: $1.23/claim|Median: $7.48
0.2× median
90734Normal range

$180

56 claims · 0.0%

Your Cost: $3.22/claim|Median: $6.40
0.5× median
99203Normal range

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

$175

324 claims · 0.0%

Your Cost: $0.54/claim|Median: $57.85
0.0× median
3512FNormal range

$165

9,962 claims · 0.0%

Your Cost: $0.02/claim|Median: $0.02
0.8× median
87389Normal range

HIV-1 antigen with HIV-1 and HIV-2 antibodies

$143

870 claims · 0.0%

Your Cost: $0.16/claim|Median: $18.03
0.0× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$132

1,481 claims · 0.0%

Your Cost: $0.09/claim|Median: $9.56
0.0× median
90715Normal range

Tdap vaccine

$127

349 claims · 0.0%

Your Cost: $0.36/claim|Median: $10.32
0.0× median
90746Normal range

Hepatitis B vaccine, adult

$116

177 claims · 0.0%

Your Cost: $0.66/claim|Median: $48.85
0.0× median
82274Normal range

$112

219 claims · 0.0%

Your Cost: $0.51/claim|Median: $12.83
0.0× median
90674Normal range

$90

1,265 claims · 0.0%

Your Cost: $0.07/claim|Median: $15.16
0.0× median
D0120Normal range

Periodic oral evaluation, established patient

$68

159 claims · 0.0%

Your Cost: $0.43/claim|Median: $24.34
0.0× median
80053Normal range

Comprehensive metabolic panel

$63

1,253 claims · 0.0%

Your Cost: $0.05/claim|Median: $7.24
0.0× median
90632Normal range

$47

24 claims · 0.0%

Your Cost: $1.94/claim|Median: $40.43
0.0× median
D0220Normal range

Intraoral periapical radiographic image, first film

$36

184 claims · 0.0%

Your Cost: $0.20/claim|Median: $10.51
0.0× median
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