Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

⚖️ Compare🖨️ Print Report

Provider 1831268580

NPI: 1831268580Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$8.9M

$8,874,940

Total Claims

566K

Beneficiaries

495K

1.1 claims/patient

Avg Cost/Claim

$16

Monthly Spending Trend

Yearly Spending

2018
$1.4M
-28%
2019
$1.0M
+12%
2020
$1.2M
-6%
2021
$1.1M
+47%
2022
$1.6M
-35%
2023
$1.0M
+41%
2024
$1.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 26% of total spending.

99213Normal range

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

$2.3M

243K claims · 26.2%

Your Cost: $9.58/claim|Median: $37.81
0.3× median
99214Normal range

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

$1.5M

89K claims · 16.4%

Your Cost: $16.26/claim|Median: $53.41
0.3× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$528K

17K claims · 6.0%

Your Cost: $31.38/claim|Median: $69.35
0.5× median
99392Normal range

Preventive medicine, established patient, age 1-4

$438K

22K claims · 4.9%

Your Cost: $19.62/claim|Median: $75.18
0.3× median
G8510Top 25%

$437K

32K claims · 4.9%

Your Cost: $13.54/claim|Median: $1.96
6.9× median
59425Top 25%

Antepartum care only, 4-6 visits

$361K

3,821 claims · 4.1%

Your Cost: $94.43/claim|Median: $63.63
1.5× median
T1013Normal range

Sign language or oral interpretive services, per 15 minutes

$297K

18K claims · 3.3%

Your Cost: $16.83/claim|Median: $17.67
1.0× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$293K

9,647 claims · 3.3%

Your Cost: $30.35/claim|Median: $23.99
1.3× median
96110Top 5%

Developmental screening, per standardized instrument

$268K

3,634 claims · 3.0%

Your Cost: $73.67/claim|Median: $9.10
8.1× median
99393Normal range

Preventive medicine, established patient, age 5-11

$192K

17K claims · 2.2%

Your Cost: $11.27/claim|Median: $74.82
0.2× median
99223Normal range

Initial hospital care, per day, high complexity

$182K

2,858 claims · 2.1%

Your Cost: $63.72/claim|Median: $67.32
0.9× median
92004Normal range

Ophthalmological exam, comprehensive, new patient

$163K

2,917 claims · 1.8%

Your Cost: $56.02/claim|Median: $59.72
0.9× median
99429Normal range

$162K

6,545 claims · 1.8%

Your Cost: $24.69/claim|Median: $28.58
0.9× median
99212Normal range

Office/outpatient visit, low complexity

$128K

14K claims · 1.4%

Your Cost: $9.19/claim|Median: $25.06
0.4× median
G9920Top 10%

$119K

3,477 claims · 1.3%

Your Cost: $34.13/claim|Median: $6.56
5.2× median
99233Normal range

Subsequent hospital care, per day, high complexity

$100K

2,645 claims · 1.1%

Your Cost: $37.95/claim|Median: $35.30
1.1× median
G0108Top 25%

Diabetes self-management training, individual

$96K

1,635 claims · 1.1%

Your Cost: $58.97/claim|Median: $35.89
1.6× median
99394Normal range

Preventive medicine, established patient, age 12-17

$96K

8,028 claims · 1.1%

Your Cost: $11.94/claim|Median: $80.15
0.1× median
99203Normal range

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

$86K

2,964 claims · 1.0%

Your Cost: $29.03/claim|Median: $57.85
0.5× median
96112Normal range

Developmental test administration

$78K

758 claims · 0.9%

Your Cost: $102.71/claim|Median: $102.95
1.0× median
93010Top 5%

Electrocardiogram, interpretation and report only

$72K

5,184 claims · 0.8%

Your Cost: $13.93/claim|Median: $5.60
2.5× median
92012Normal range

Ophthalmological exam, intermediate, established patient

$66K

1,783 claims · 0.7%

Your Cost: $37.11/claim|Median: $38.23
1.0× median
92015Normal range

Determination of refractive state

$63K

6,376 claims · 0.7%

Your Cost: $9.81/claim|Median: $10.36
0.9× median
92014Normal range

Ophthalmological exam, comprehensive, established patient

$62K

2,103 claims · 0.7%

Your Cost: $29.51/claim|Median: $47.08
0.6× median
99078Normal range

$56K

2,430 claims · 0.6%

Your Cost: $23.23/claim|Median: $25.66
0.9× median
99442Normal range

Telephone E/M by physician, 11-20 minutes

$55K

2,197 claims · 0.6%

Your Cost: $25.08/claim|Median: $22.44
1.1× median
20610Top 25%

Arthrocentesis, aspiration/injection, major joint

$53K

1,097 claims · 0.6%

Your Cost: $48.64/claim|Median: $29.03
1.7× median
99231Normal range

Subsequent hospital care, per day, low complexity

$53K

2,451 claims · 0.6%

Your Cost: $21.70/claim|Median: $16.77
1.3× median
99239Normal range

Hospital discharge day management, more than 30 minutes

$52K

1,068 claims · 0.6%

Your Cost: $48.34/claim|Median: $43.85
1.1× median
93306Normal range

Echocardiography, transthoracic, complete, with Doppler

$44K

576 claims · 0.5%

Your Cost: $76.30/claim|Median: $54.68
1.4× median
← All providersHow we detect fraud →