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EDINBURG PEDIATRIC NETWORK LLC

General Practice·PHARR, TX·NPI: 1669708780Share

Compared to General Practice Peers

Total spending distribution among 6 providers in this specialty

P25MedianP75P90

This provider's total spending of $37.3M is at the 50th percentile among 6 General Practice providers.

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

Total Paid

$37.3M

$37,302,121

Total Claims

1.7M

Beneficiaries

1.4M

1.2 claims/patient

Avg Cost/Claim

$22

Monthly Spending Trend

Yearly Spending

2018
$166K
+8%
2019
$179K
+1010%
2020
$2.0M
+335%
2021
$8.7M
+32%
2022
$11.4M
-17%
2023
$9.5M
-43%
2024
$5.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 25% of total spending.

99213Normal range

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

$9.3M

323K claims · 24.8%

Your Cost: $28.64/claim|Median: $37.81
0.8× median
87426Top 25%

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

$6.3M

156K claims · 16.8%

Your Cost: $40.07/claim|Median: $30.04
1.3× median
S8301Top 5%

$5.2M

178K claims · 13.9%

Your Cost: $29.08/claim|Median: $8.32
3.5× median
87804Normal range

Influenza virus detection, rapid test

$2.3M

246K claims · 6.1%

Your Cost: $9.18/claim|Median: $12.59
0.7× median
99393Normal range

Preventive medicine, established patient, age 5-11

$2.0M

26K claims · 5.4%

Your Cost: $78.39/claim|Median: $74.82
1.0× median
99394Normal range

Preventive medicine, established patient, age 12-17

$1.8M

22K claims · 4.7%

Your Cost: $80.77/claim|Median: $80.15
1.0× median
99392Normal range

Preventive medicine, established patient, age 1-4

$1.7M

23K claims · 4.5%

Your Cost: $74.34/claim|Median: $75.18
1.0× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$1.3M

137K claims · 3.4%

Your Cost: $9.27/claim|Median: $11.48
0.8× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$1.1M

105K claims · 2.9%

Your Cost: $10.44/claim|Median: $17.85
0.6× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$902K

12K claims · 2.4%

Your Cost: $72.73/claim|Median: $69.35
1.0× median
99050Top 5%

$823K

14K claims · 2.2%

Your Cost: $60.77/claim|Median: $11.81
5.1× median
99214Normal range

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

$814K

24K claims · 2.2%

Your Cost: $33.30/claim|Median: $53.41
0.6× median
99429Normal range

$533K

16K claims · 1.4%

Your Cost: $32.34/claim|Median: $28.58
1.1× median
85025Normal range

Complete blood count (CBC) with differential, automated

$326K

74K claims · 0.9%

Your Cost: $4.39/claim|Median: $4.71
0.9× median
99395Normal range

Preventive medicine, established patient, age 18-39

$247K

3,193 claims · 0.7%

Your Cost: $77.34/claim|Median: $72.71
1.1× median
87807Normal range

$226K

31K claims · 0.6%

Your Cost: $7.32/claim|Median: $10.06
0.7× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$221K

4,911 claims · 0.6%

Your Cost: $45.10/claim|Median: $39.70
1.1× median
96110Normal range

Developmental screening, per standardized instrument

$216K

27K claims · 0.6%

Your Cost: $7.95/claim|Median: $9.10
0.9× median
99381Normal range

Preventive visit, new patient, infant (<1 yr)

$196K

2,552 claims · 0.5%

Your Cost: $76.97/claim|Median: $73.46
1.0× median
99203Normal range

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

$181K

4,189 claims · 0.5%

Your Cost: $43.13/claim|Median: $57.85
0.7× median
87428Normal range

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

$154K

3,981 claims · 0.4%

Your Cost: $38.74/claim|Median: $39.63
1.0× median
99212Normal range

Office/outpatient visit, low complexity

$142K

7,612 claims · 0.4%

Your Cost: $18.62/claim|Median: $25.06
0.7× median
97803Normal range

Medical nutrition therapy, reassessment, group, thirty minutes

$117K

6,018 claims · 0.3%

Your Cost: $19.47/claim|Median: $24.33
0.8× median
99000Top 25%

$114K

16K claims · 0.3%

Your Cost: $7.27/claim|Median: $2.30
3.2× median
90461Normal range

Immunization admin, additional vaccine, counseling

$109K

16K claims · 0.3%

Your Cost: $7.02/claim|Median: $6.93
1.0× median
97802Normal range

Medical nutrition therapy, reassessment, individual, fifteen minutes

$99K

2,797 claims · 0.3%

Your Cost: $35.30/claim|Median: $12.70
2.8× median
87811Top 25%

SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-read

$90K

2,396 claims · 0.2%

Your Cost: $37.59/claim|Median: $30.53
1.2× median
87301Normal range

$69K

11K claims · 0.2%

Your Cost: $6.47/claim|Median: $7.18
0.9× median
84443Normal range

Thyroid stimulating hormone (TSH)

$69K

6,949 claims · 0.2%

Your Cost: $9.88/claim|Median: $9.87
1.0× median
0001ANormal range

COVID-19 vaccine admin, Pfizer, 1st dose

$68K

1,752 claims · 0.2%

Your Cost: $38.58/claim|Median: $33.72
1.1× median
0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$64K

1,645 claims · 0.2%

Your Cost: $39.12/claim|Median: $36.70
1.1× median
84481Normal range

$58K

6,097 claims · 0.2%

Your Cost: $9.46/claim|Median: $9.37
1.0× median
83525Normal range

$55K

8,136 claims · 0.1%

Your Cost: $6.74/claim|Median: $8.83
0.8× median
0071ANormal range

$51K

1,548 claims · 0.1%

Your Cost: $33.03/claim|Median: $38.71
0.9× median
80061Normal range

Lipid panel

$47K

6,245 claims · 0.1%

Your Cost: $7.45/claim|Median: $8.41
0.9× median
96161Normal range

$44K

22K claims · 0.1%

Your Cost: $2.01/claim|Median: $2.49
0.8× median
99211Normal range

Office/outpatient visit, minimal complexity

$41K

3,899 claims · 0.1%

Your Cost: $10.44/claim|Median: $12.93
0.8× median
G8510Top 25%

$37K

3,601 claims · 0.1%

Your Cost: $10.25/claim|Median: $1.96
5.2× median
0072ANormal range

$34K

870 claims · 0.1%

Your Cost: $39.35/claim|Median: $39.57
1.0× median
99051Normal range

$34K

8,036 claims · 0.1%

Your Cost: $4.22/claim|Median: $7.89
0.5× median
84439Normal range

Free thyroxine level blood test

$32K

6,186 claims · 0.1%

Your Cost: $5.23/claim|Median: $6.31
0.8× median
80053Normal range

Comprehensive metabolic panel

$31K

5,224 claims · 0.1%

Your Cost: $5.97/claim|Median: $7.24
0.8× median
87631Normal range

Respiratory virus detection, 3-5 targets, multiplex

$28K

397 claims · 0.1%

Your Cost: $69.71/claim|Median: $65.45
1.1× median
83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$24K

4,264 claims · 0.1%

Your Cost: $5.62/claim|Median: $5.50
1.0× median
81003Normal range

Urinalysis, automated without microscopy

$18K

14K claims · 0.0%

Your Cost: $1.33/claim|Median: $1.48
0.9× median
80050Normal range

General health panel

$17K

674 claims · 0.0%

Your Cost: $25.15/claim|Median: $25.59
1.0× median
87502Normal range

Influenza virus detection, reverse transcription, amplified probe

$15K

188 claims · 0.0%

Your Cost: $77.87/claim|Median: $65.64
1.2× median
S9470Top 25%

Nutritional counseling

$14K

359 claims · 0.0%

Your Cost: $39.30/claim|Median: $16.62
2.4× median
86328Normal range

$13K

570 claims · 0.0%

Your Cost: $23.34/claim|Median: $20.52
1.1× median
87633Top 25%

Respiratory virus detection, 12-25 targets, nucleic acid

$13K

35 claims · 0.0%

Your Cost: $379.39/claim|Median: $169.17
2.2× median

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