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Unknown Provider 1790075315

NPI: 1790075315Share
Active Billing Period:2018-01→2022-10(58 months)
Billing appears to have stoppedLast active: 2022-10

Total Paid

$21.6M

$21,554,839

Total Claims

196K

Beneficiaries

160K

1.2 claims/patient

Avg Cost/Claim

$110

Monthly Spending Trend

Yearly Spending

2018
$5.0M
-4%
2019
$4.9M
+17%
2020
$5.7M
-25%
2021
$4.3M
-61%
2022
$1.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 81% of total spending.

T1015Top 25%

Clinic visit/encounter, all-inclusive

$17.5M

84K claims · 81.1%

Your Cost: $208.24/claim|Median: $121.16
1.7× median
00003Normal range

Anesthesia services

$4.0M

17K claims · 18.4%

Your Cost: $239.29/claim|Median: $223.77
1.1× median
99213Normal range

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

$69K

31K claims · 0.3%

Your Cost: $2.21/claim|Median: $37.81
0.1× median
99212Normal range

Office/outpatient visit, low complexity

$10K

15K claims · 0.0%

Your Cost: $0.66/claim|Median: $25.06
0.0× median
0012ANormal range

COVID-19 vaccine admin, Moderna, 2nd dose

$8K

242 claims · 0.0%

Your Cost: $32.67/claim|Median: $33.85
1.0× median
0011ANormal range

COVID-19 vaccine admin, Moderna, 1st dose

$7K

239 claims · 0.0%

Your Cost: $29.83/claim|Median: $25.93
1.2× median
0001ANormal range

COVID-19 vaccine admin, Pfizer, 1st dose

$7K

185 claims · 0.0%

Your Cost: $35.73/claim|Median: $33.72
1.1× median
0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$5K

138 claims · 0.0%

Your Cost: $38.04/claim|Median: $36.70
1.0× median
99203Normal range

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

$3K

2,149 claims · 0.0%

Your Cost: $1.25/claim|Median: $57.85
0.0× median
0071ANormal range

$2K

59 claims · 0.0%

Your Cost: $39.32/claim|Median: $38.71
1.0× median
0072ANormal range

$2K

39 claims · 0.0%

Your Cost: $38.97/claim|Median: $39.57
1.0× median
0031ANormal range

COVID-19 vaccine admin, J&J, single dose

$1K

46 claims · 0.0%

Your Cost: $28.26/claim|Median: $32.49
0.9× median
99000Normal range

$801

6,633 claims · 0.0%

Your Cost: $0.12/claim|Median: $2.30
0.1× median
0004ANormal range

$570

16 claims · 0.0%

Your Cost: $35.64/claim|Median: $35.62
1.0× median
81025Normal range

Urine pregnancy test

$484

255 claims · 0.0%

Your Cost: $1.90/claim|Median: $4.81
0.4× median
90715Normal range

Tdap vaccine

$253

568 claims · 0.0%

Your Cost: $0.44/claim|Median: $10.32
0.0× median
90471Normal range

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

$229

4,230 claims · 0.0%

Your Cost: $0.05/claim|Median: $9.80
0.0× median
99382Normal range

Preventive visit, new patient, early childhood (1-4 yr)

$157

124 claims · 0.0%

Your Cost: $1.27/claim|Median: $79.89
0.0× median
92551Normal range

Screening audiometry, pure tone, air only

$136

430 claims · 0.0%

Your Cost: $0.32/claim|Median: $6.61
0.0× median
92552Normal range

Pure tone audiometry, air only, each ear

$121

1,071 claims · 0.0%

Your Cost: $0.11/claim|Median: $12.63
0.0× median
99214Normal range

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

$91

1,455 claims · 0.0%

Your Cost: $0.06/claim|Median: $53.41
0.0× median
99384Normal range

Preventive visit, new patient, adolescent (12-17 yr)

$65

197 claims · 0.0%

Your Cost: $0.33/claim|Median: $83.63
0.0× median
99201Normal range

Office/outpatient visit, new patient, straightforward

$56

205 claims · 0.0%

Your Cost: $0.27/claim|Median: $27.38
0.0× median
99383Normal range

Preventive visit, new patient, late childhood (5-11 yr)

$55

364 claims · 0.0%

Your Cost: $0.15/claim|Median: $81.92
0.0× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$34

147 claims · 0.0%

Your Cost: $0.23/claim|Median: $40.11
0.0× median
85018Normal range

$16

814 claims · 0.0%

Your Cost: $0.02/claim|Median: $1.71
0.0× median
90472Normal range

Immunization administration, each additional vaccine

$12

2,106 claims · 0.0%

Your Cost: $0.01/claim|Median: $11.79
0.0× median
99211Normal range

Office/outpatient visit, minimal complexity

$12

194 claims · 0.0%

Your Cost: $0.06/claim|Median: $12.93
0.0× median
90696Normal range

DTaP-IPV vaccine

$6

83 claims · 0.0%

Your Cost: $0.07/claim|Median: $5.95
0.0× median
90633Normal range

$6

443 claims · 0.0%

Your Cost: $0.01/claim|Median: $3.56
0.0× median
81003Normal range

Urinalysis, automated without microscopy

$3

90 claims · 0.0%

Your Cost: $0.03/claim|Median: $1.48
0.0× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$0

583 claims · 0.0%

Your Cost: $0.00/claim|Median: $69.35
99204Normal range

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

$0

25 claims · 0.0%

Your Cost: $0.00/claim|Median: $84.03
90832Normal range

Psychotherapy, 30 minutes

$0

143 claims · 0.0%

Your Cost: $0.00/claim|Median: $41.28
99393Normal range

Preventive medicine, established patient, age 5-11

$0

725 claims · 0.0%

Your Cost: $0.00/claim|Median: $74.82
G0447Normal range

$0

180 claims · 0.0%

Your Cost: $0.00/claim|Median: $5.19
G8431Normal range

$0

131 claims · 0.0%

Your Cost: $0.00/claim|Median: $2.37
83655Normal range

$0

247 claims · 0.0%

Your Cost: $0.00/claim|Median: $10.49
3078FNormal range

$0

150 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.08
99395Normal range

Preventive medicine, established patient, age 18-39

$0

361 claims · 0.0%

Your Cost: $0.00/claim|Median: $72.71
81002Normal range

Urinalysis, non-automated without microscopy

$0

51 claims · 0.0%

Your Cost: $0.00/claim|Median: $2.00
81000Normal range

Urinalysis with microscopy, non-automated

$0

47 claims · 0.0%

Your Cost: $0.00/claim|Median: $2.51
90681Normal range

$0

120 claims · 0.0%

Your Cost: $0.00/claim|Median: $5.74
99173Normal range

$0

1,580 claims · 0.0%

Your Cost: $0.00/claim|Median: $2.16
82948Normal range

$0

13 claims · 0.0%

Your Cost: $0.00/claim|Median: $1.78
90734Normal range

$0

292 claims · 0.0%

Your Cost: $0.00/claim|Median: $6.40
3008FNormal range

$0

656 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.06
Z1032Normal range

$0

195 claims · 0.0%

Your Cost: $0.00/claim|Median: $147.33
96110Normal range

Developmental screening, per standardized instrument

$0

236 claims · 0.0%

Your Cost: $0.00/claim|Median: $9.10
96150Normal range

Health behavior assessment, initial

$0

27 claims · 0.0%

Your Cost: $0.00/claim|Median: $17.83
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