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Provider 1659323442

NPI: 1659323442Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$14.7M

$14,730,775

Total Claims

372K

Beneficiaries

312K

1.2 claims/patient

Avg Cost/Claim

$40

Monthly Spending Trend

Yearly Spending

2018
$2.4M
+5%
2019
$2.6M
-29%
2020
$1.8M
+6%
2021
$1.9M
-3%
2022
$1.9M
+15%
2023
$2.1M
-4%
2024
$2.0M

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 74% of total spending.

T1015Top 25%

Clinic visit/encounter, all-inclusive

$10.9M

59K claims · 74.1%

Your Cost: $186.01/claim|Median: $121.16
1.5× median
99213Normal range

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

$1.7M

109K claims · 11.8%

Your Cost: $16.00/claim|Median: $37.81
0.4× median
D0120Top 1%

Periodic oral evaluation, established patient

$667K

5,250 claims · 4.5%

Your Cost: $127.06/claim|Median: $24.34
5.2× median
90471Normal range

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

$152K

17K claims · 1.0%

Your Cost: $9.04/claim|Median: $9.80
0.9× median
99392Normal range

Preventive medicine, established patient, age 1-4

$139K

5,257 claims · 0.9%

Your Cost: $26.43/claim|Median: $75.18
0.4× median
99211Top 25%

Office/outpatient visit, minimal complexity

$117K

4,288 claims · 0.8%

Your Cost: $27.31/claim|Median: $12.93
2.1× median
90832Normal range

Psychotherapy, 30 minutes

$115K

23K claims · 0.8%

Your Cost: $5.05/claim|Median: $41.28
0.1× median
99214Normal range

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

$105K

5,658 claims · 0.7%

Your Cost: $18.58/claim|Median: $53.41
0.3× median
90472Normal range

Immunization administration, each additional vaccine

$104K

8,940 claims · 0.7%

Your Cost: $11.67/claim|Median: $11.79
1.0× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$99K

6,879 claims · 0.7%

Your Cost: $14.32/claim|Median: $69.35
0.2× median
99393Normal range

Preventive medicine, established patient, age 5-11

$88K

2,959 claims · 0.6%

Your Cost: $29.87/claim|Median: $74.82
0.4× median
99212Normal range

Office/outpatient visit, low complexity

$79K

4,321 claims · 0.5%

Your Cost: $18.30/claim|Median: $25.06
0.7× median
99394Normal range

Preventive medicine, established patient, age 12-17

$59K

1,752 claims · 0.4%

Your Cost: $33.93/claim|Median: $80.15
0.4× median
90671Top 25%

$45K

1,552 claims · 0.3%

Your Cost: $28.98/claim|Median: $8.59
3.4× median
92551Normal range

Screening audiometry, pure tone, air only

$39K

10K claims · 0.3%

Your Cost: $3.80/claim|Median: $6.61
0.6× median
90697Top 25%

$37K

1,495 claims · 0.3%

Your Cost: $24.75/claim|Median: $7.24
3.4× median
99396Normal range

Preventive medicine, established patient, age 40-64

$30K

848 claims · 0.2%

Your Cost: $35.79/claim|Median: $76.06
0.5× median
99173Normal range

$18K

11K claims · 0.1%

Your Cost: $1.57/claim|Median: $2.16
0.7× median
0012ANormal range

COVID-19 vaccine admin, Moderna, 2nd dose

$18K

528 claims · 0.1%

Your Cost: $33.19/claim|Median: $33.85
1.0× median
96110Normal range

Developmental screening, per standardized instrument

$17K

1,209 claims · 0.1%

Your Cost: $13.73/claim|Median: $9.10
1.5× median
G0447Normal range

$15K

14K claims · 0.1%

Your Cost: $1.07/claim|Median: $5.19
0.2× median
0011ANormal range

COVID-19 vaccine admin, Moderna, 1st dose

$11K

392 claims · 0.1%

Your Cost: $29.23/claim|Median: $25.93
1.1× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$9K

4,303 claims · 0.1%

Your Cost: $2.15/claim|Median: $7.18
0.3× median
81025Normal range

Urine pregnancy test

$9K

4,750 claims · 0.1%

Your Cost: $1.91/claim|Median: $4.81
0.4× median
59025Normal range

Fetal non-stress test

$8K

316 claims · 0.1%

Your Cost: $23.98/claim|Median: $26.45
0.9× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$7K

374 claims · 0.0%

Your Cost: $19.13/claim|Median: $39.70
0.5× median
99395Normal range

Preventive medicine, established patient, age 18-39

$6K

166 claims · 0.0%

Your Cost: $39.13/claim|Median: $72.71
0.5× median
81002Normal range

Urinalysis, non-automated without microscopy

$6K

15K claims · 0.0%

Your Cost: $0.42/claim|Median: $2.00
0.2× median
90658Top 25%

$5K

344 claims · 0.0%

Your Cost: $14.86/claim|Median: $8.96
1.7× median
G0467Normal range

Federally qualified health center visit, mental health

$5K

5,314 claims · 0.0%

Your Cost: $0.88/claim|Median: $21.91
0.0× median
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