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SUMMIT MEDICAL GROUP, INC

Family Medicine·ERLANGER, KY·NPI: 1750343216Share

Compared to Family Medicine Peers

Total spending distribution among 19 providers in this specialty

P25MedianP75P90

This provider's total spending of $94.8M is at the 75th percentile among 19 Family Medicine providers.

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

Total Paid

$94.8M

$94,782,942

Total Claims

2.6M

Beneficiaries

2.1M

1.2 claims/patient

Avg Cost/Claim

$37

Monthly Spending Trend

Yearly Spending

2018
$10.6M
+9%
2019
$11.6M
+5%
2020
$12.1M
+33%
2021
$16.1M
-3%
2022
$15.6M
+3%
2023
$16.0M
-20%
2024
$12.8M

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 29% of total spending.

99213Normal range

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

$27.4M

748K claims · 28.9%

Your Cost: $36.61/claim|Median: $37.81
1.0× median
99214Normal range

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

$22.1M

445K claims · 23.4%

Your Cost: $49.76/claim|Median: $53.41
0.9× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$7.0M

248K claims · 7.4%

Your Cost: $28.32/claim|Median: $23.99
1.2× median
99233Normal range

Subsequent hospital care, per day, high complexity

$4.2M

104K claims · 4.4%

Your Cost: $39.79/claim|Median: $35.30
1.1× median
99223Normal range

Initial hospital care, per day, high complexity

$3.5M

42K claims · 3.7%

Your Cost: $84.30/claim|Median: $67.32
1.3× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$2.3M

45K claims · 2.4%

Your Cost: $50.37/claim|Median: $43.85
1.1× median
99392Normal range

Preventive medicine, established patient, age 1-4

$1.6M

21K claims · 1.7%

Your Cost: $76.93/claim|Median: $75.18
1.0× median
90460Top 25%

Immunization administration, first vaccine/toxoid, with counseling

$1.6M

41K claims · 1.7%

Your Cost: $38.84/claim|Median: $17.85
2.2× median
90833Normal range

Psychotherapy, 30 min, add-on to E/M service

$1.5M

45K claims · 1.6%

Your Cost: $33.43/claim|Median: $38.83
0.9× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$1.5M

22K claims · 1.6%

Your Cost: $68.07/claim|Median: $69.35
1.0× median
99291Normal range

Critical care, first 30-74 minutes

$1.1M

11K claims · 1.2%

Your Cost: $104.82/claim|Median: $101.24
1.0× median
99204Normal range

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

$1.1M

14K claims · 1.2%

Your Cost: $82.07/claim|Median: $84.03
1.0× median
J0585Normal range

Injection, onabotulinumtoxinA, 1 unit

$1.1M

2,228 claims · 1.1%

Your Cost: $488.77/claim|Median: $470.36
1.0× median
99254Normal range

$1.1M

12K claims · 1.1%

Your Cost: $85.67/claim|Median: $81.43
1.1× median
93010Normal range

Electrocardiogram, interpretation and report only

$1.0M

147K claims · 1.1%

Your Cost: $6.87/claim|Median: $5.60
1.2× median
99393Normal range

Preventive medicine, established patient, age 5-11

$932K

12K claims · 1.0%

Your Cost: $75.70/claim|Median: $74.82
1.0× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$868K

11K claims · 0.9%

Your Cost: $81.90/claim|Median: $108.91
0.8× median
90471Top 25%

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

$774K

50K claims · 0.8%

Your Cost: $15.61/claim|Median: $9.80
1.6× median
93306Normal range

Echocardiography, transthoracic, complete, with Doppler

$738K

19K claims · 0.8%

Your Cost: $39.58/claim|Median: $54.68
0.7× median
99244Normal range

Office or other outpatient consultation, moderate complexity

$721K

6,242 claims · 0.8%

Your Cost: $115.51/claim|Median: $121.58
1.0× median
90461Top 10%

Immunization admin, additional vaccine, counseling

$670K

16K claims · 0.7%

Your Cost: $42.21/claim|Median: $6.93
6.1× median
99203Normal range

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

$570K

9,641 claims · 0.6%

Your Cost: $59.16/claim|Median: $57.85
1.0× median
87880Top 25%

Streptococcus, Group A, rapid antigen detection

$545K

38K claims · 0.6%

Your Cost: $14.44/claim|Median: $11.48
1.3× median
99222Normal range

Initial hospital care, per day, moderate complexity

$535K

8,239 claims · 0.6%

Your Cost: $64.90/claim|Median: $51.25
1.3× median
87426Normal range

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

$517K

20K claims · 0.5%

Your Cost: $26.33/claim|Median: $30.04
0.9× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$480K

12K claims · 0.5%

Your Cost: $39.65/claim|Median: $37.22
1.1× median
87804Normal range

Influenza virus detection, rapid test

$431K

30K claims · 0.5%

Your Cost: $14.24/claim|Median: $12.59
1.1× median
59025Normal range

Fetal non-stress test

$390K

17K claims · 0.4%

Your Cost: $23.19/claim|Median: $26.45
0.9× median
99396Normal range

Preventive medicine, established patient, age 40-64

$387K

4,105 claims · 0.4%

Your Cost: $94.35/claim|Median: $76.06
1.2× median
99395Normal range

Preventive medicine, established patient, age 18-39

$361K

4,878 claims · 0.4%

Your Cost: $73.98/claim|Median: $72.71
1.0× median
99394Normal range

Preventive medicine, established patient, age 12-17

$329K

3,951 claims · 0.3%

Your Cost: $83.25/claim|Median: $80.15
1.0× median
90837Normal range

Psychotherapy, 60 minutes

$309K

4,553 claims · 0.3%

Your Cost: $67.93/claim|Median: $85.66
0.8× median
95886Normal range

$301K

5,400 claims · 0.3%

Your Cost: $55.65/claim|Median: $67.70
0.8× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$297K

21K claims · 0.3%

Your Cost: $13.93/claim|Median: $9.56
1.5× median
95810Normal range

Polysomnography, sleep study, 6+ hours

$279K

2,583 claims · 0.3%

Your Cost: $108.13/claim|Median: $233.73
0.5× median
59426Normal range

Antepartum care only, high risk, additional visits

$278K

3,495 claims · 0.3%

Your Cost: $79.42/claim|Median: $122.30
0.6× median
99212Normal range

Office/outpatient visit, low complexity

$259K

10K claims · 0.3%

Your Cost: $25.51/claim|Median: $25.06
1.0× median
99255Normal range

$254K

2,254 claims · 0.3%

Your Cost: $112.63/claim|Median: $90.45
1.2× median
90472Normal range

Immunization administration, each additional vaccine

$253K

16K claims · 0.3%

Your Cost: $15.66/claim|Median: $11.79
1.3× median
87400Top 25%

$250K

10K claims · 0.3%

Your Cost: $23.94/claim|Median: $8.40
2.9× median
99231Normal range

Subsequent hospital care, per day, low complexity

$235K

13K claims · 0.2%

Your Cost: $18.00/claim|Median: $16.77
1.1× median
59409Normal range

Vaginal delivery only

$220K

355 claims · 0.2%

Your Cost: $619.84/claim|Median: $619.91
1.0× median
59425Normal range

Antepartum care only, 4-6 visits

$197K

2,341 claims · 0.2%

Your Cost: $84.21/claim|Median: $63.63
1.3× median
99253Normal range

$189K

3,279 claims · 0.2%

Your Cost: $57.55/claim|Median: $55.16
1.0× median
43239Normal range

Upper GI endoscopy with biopsy

$184K

1,890 claims · 0.2%

Your Cost: $97.28/claim|Median: $151.68
0.6× median
80305Top 25%

$183K

18K claims · 0.2%

Your Cost: $10.36/claim|Median: $7.44
1.4× median
11042Normal range

Debridement, subcutaneous tissue, first 20 sq cm

$183K

9,290 claims · 0.2%

Your Cost: $19.71/claim|Median: $36.13
0.5× median
99215Normal range

Office/outpatient visit, high complexity

$143K

2,030 claims · 0.2%

Your Cost: $70.39/claim|Median: $74.09
1.0× median
92014Normal range

Ophthalmological exam, comprehensive, established patient

$142K

3,295 claims · 0.1%

Your Cost: $42.96/claim|Median: $47.08
0.9× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$131K

1,351 claims · 0.1%

Your Cost: $96.74/claim|Median: $111.09
0.9× median

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