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Provider 1710211214

NPI: 1710211214Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$15.0M

$14,974,643

Total Claims

574K

Beneficiaries

409K

1.4 claims/patient

Avg Cost/Claim

$26

Monthly Spending Trend

Yearly Spending

2018
$2.4M
-14%
2019
$2.0M
+15%
2020
$2.4M
-1%
2021
$2.3M
-24%
2022
$1.8M
+13%
2023
$2.0M
+6%
2024
$2.1M

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 86% of total spending.

T1015Normal range

Clinic visit/encounter, all-inclusive

$12.8M

138K claims · 85.6%

Your Cost: $92.57/claim|Median: $121.16
0.8× median
99213Normal range

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

$381K

109K claims · 2.5%

Your Cost: $3.50/claim|Median: $37.81
0.1× median
90471Normal range

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

$270K

26K claims · 1.8%

Your Cost: $10.32/claim|Median: $9.80
1.1× median
90791Normal range

Psychiatric diagnostic evaluation

$248K

3,044 claims · 1.7%

Your Cost: $81.36/claim|Median: $99.21
0.8× median
90832Normal range

Psychotherapy, 30 minutes

$239K

7,177 claims · 1.6%

Your Cost: $33.29/claim|Median: $41.28
0.8× median
59425Normal range

Antepartum care only, 4-6 visits

$180K

2,492 claims · 1.2%

Your Cost: $72.36/claim|Median: $63.63
1.1× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$149K

53K claims · 1.0%

Your Cost: $2.79/claim|Median: $3.67
0.8× median
99214Normal range

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

$110K

36K claims · 0.7%

Your Cost: $3.09/claim|Median: $53.41
0.1× median
96110Top 10%

Developmental screening, per standardized instrument

$106K

4,170 claims · 0.7%

Your Cost: $25.47/claim|Median: $9.10
2.8× median
D1206Normal range

Topical application of fluoride varnish

$47K

3,506 claims · 0.3%

Your Cost: $13.37/claim|Median: $18.12
0.7× median
90746Normal range

Hepatitis B vaccine, adult

$43K

786 claims · 0.3%

Your Cost: $54.45/claim|Median: $48.85
1.1× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$43K

11K claims · 0.3%

Your Cost: $3.83/claim|Median: $7.18
0.5× median
99212Normal range

Office/outpatient visit, low complexity

$37K

11K claims · 0.2%

Your Cost: $3.42/claim|Median: $25.06
0.1× median
99396Normal range

Preventive medicine, established patient, age 40-64

$34K

2,240 claims · 0.2%

Your Cost: $14.99/claim|Median: $76.06
0.2× median
99395Normal range

Preventive medicine, established patient, age 18-39

$32K

2,209 claims · 0.2%

Your Cost: $14.65/claim|Median: $72.71
0.2× median
99173Normal range

$27K

13K claims · 0.2%

Your Cost: $2.05/claim|Median: $2.16
1.0× median
J3490Top 25%

Unclassified drugs

$25K

576 claims · 0.2%

Your Cost: $43.77/claim|Median: $5.70
7.7× median
G0467Normal range

Federally qualified health center visit, mental health

$18K

651 claims · 0.1%

Your Cost: $27.23/claim|Median: $21.91
1.2× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$17K

3,623 claims · 0.1%

Your Cost: $4.76/claim|Median: $69.35
0.1× median
90715Normal range

Tdap vaccine

$17K

1,478 claims · 0.1%

Your Cost: $11.44/claim|Median: $10.32
1.1× median
99392Normal range

Preventive medicine, established patient, age 1-4

$14K

6,961 claims · 0.1%

Your Cost: $2.02/claim|Median: $75.18
0.0× median
99394Normal range

Preventive medicine, established patient, age 12-17

$12K

5,005 claims · 0.1%

Your Cost: $2.30/claim|Median: $80.15
0.0× median
0011ATop 5%

COVID-19 vaccine admin, Moderna, 1st dose

$11K

169 claims · 0.1%

Your Cost: $65.22/claim|Median: $25.93
2.5× median
99393Normal range

Preventive medicine, established patient, age 5-11

$10K

6,289 claims · 0.1%

Your Cost: $1.62/claim|Median: $74.82
0.0× median
81003Normal range

Urinalysis, automated without microscopy

$7K

7,376 claims · 0.0%

Your Cost: $0.98/claim|Median: $1.48
0.7× median
92552Normal range

Pure tone audiometry, air only, each ear

$6K

12K claims · 0.0%

Your Cost: $0.50/claim|Median: $12.63
0.0× median
99203Normal range

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

$6K

328 claims · 0.0%

Your Cost: $17.58/claim|Median: $57.85
0.3× median
90732Normal range

Pneumococcal vaccine (PPSV23)

$6K

114 claims · 0.0%

Your Cost: $50.35/claim|Median: $36.96
1.4× median
0012ATop 5%

COVID-19 vaccine admin, Moderna, 2nd dose

$5K

81 claims · 0.0%

Your Cost: $67.00/claim|Median: $33.85
2.0× median
G9012Normal range

Other specified case management service, per 15 minutes

$5K

70 claims · 0.0%

Your Cost: $72.43/claim|Median: $137.85
0.5× median
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