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

⚖️ Compare🖨️ Print Report

Provider 1861560765

NPI: 1861560765Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$9.0M

$9,010,743

Total Claims

180K

Beneficiaries

173K

1.0 claims/patient

Avg Cost/Claim

$50

Monthly Spending Trend

Yearly Spending

2018
$1.1M
-5%
2019
$1.1M
-1%
2020
$1.0M
+41%
2021
$1.5M
+4%
2022
$1.5M
-1%
2023
$1.5M
-13%
2024
$1.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 29% of total spending.

99214Top 10%

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

$2.6M

26K claims · 28.5%

Your Cost: $99.60/claim|Median: $53.41
1.9× median
99213Top 25%

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

$2.0M

30K claims · 22.4%

Your Cost: $68.28/claim|Median: $37.81
1.8× median
90460Top 25%

Immunization administration, first vaccine/toxoid, with counseling

$808K

25K claims · 9.0%

Your Cost: $32.65/claim|Median: $17.85
1.8× median
99391Top 25%

Preventive medicine, established patient, infant (under 1)

$782K

8,326 claims · 8.7%

Your Cost: $93.93/claim|Median: $69.35
1.4× median
99392Top 25%

Preventive medicine, established patient, age 1-4

$752K

7,473 claims · 8.3%

Your Cost: $100.58/claim|Median: $75.18
1.3× median
99393Top 25%

Preventive medicine, established patient, age 5-11

$658K

6,513 claims · 7.3%

Your Cost: $101.05/claim|Median: $74.82
1.4× median
99394Top 25%

Preventive medicine, established patient, age 12-17

$412K

3,655 claims · 4.6%

Your Cost: $112.70/claim|Median: $80.15
1.4× median
90461Normal range

Immunization admin, additional vaccine, counseling

$170K

7,671 claims · 1.9%

Your Cost: $22.12/claim|Median: $6.93
3.2× median
87635Top 10%

COVID-19 SARS-CoV-2 amplified probe detection

$133K

2,543 claims · 1.5%

Your Cost: $52.14/claim|Median: $39.70
1.3× median
87811Top 5%

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

$122K

2,896 claims · 1.4%

Your Cost: $42.01/claim|Median: $30.53
1.4× median
99212Top 25%

Office/outpatient visit, low complexity

$106K

2,556 claims · 1.2%

Your Cost: $41.33/claim|Median: $25.06
1.6× median
G2023Normal range

Specimen collection for COVID-19 testing

$91K

4,091 claims · 1.0%

Your Cost: $22.15/claim|Median: $17.15
1.3× median
87804Top 25%

Influenza virus detection, rapid test

$84K

3,989 claims · 0.9%

Your Cost: $20.95/claim|Median: $12.59
1.7× median
99460Top 25%

Initial hospital or birthing center care, newborn, per day

$53K

604 claims · 0.6%

Your Cost: $87.64/claim|Median: $62.48
1.4× median
99051Normal range

$47K

4,012 claims · 0.5%

Your Cost: $11.82/claim|Median: $7.89
1.5× median
99238Top 10%

Hospital discharge day management, 30 minutes or less

$44K

644 claims · 0.5%

Your Cost: $67.83/claim|Median: $37.22
1.8× median
87651Normal range

Streptococcus Group A detection, nucleic acid, amplified probe

$27K

977 claims · 0.3%

Your Cost: $27.52/claim|Median: $28.46
1.0× median
87502Normal range

Influenza virus detection, reverse transcription, amplified probe

$26K

334 claims · 0.3%

Your Cost: $79.20/claim|Median: $65.64
1.2× median
83655Top 25%

$21K

1,660 claims · 0.2%

Your Cost: $12.77/claim|Median: $10.49
1.2× median
92551Normal range

Screening audiometry, pure tone, air only

$16K

3,246 claims · 0.2%

Your Cost: $4.96/claim|Median: $6.61
0.8× median
87880Top 25%

Streptococcus, Group A, rapid antigen detection

$11K

794 claims · 0.1%

Your Cost: $14.03/claim|Median: $11.48
1.2× median
99462Normal range

$11K

323 claims · 0.1%

Your Cost: $33.25/claim|Median: $27.49
1.2× median
85018Top 25%

$8K

3,448 claims · 0.1%

Your Cost: $2.46/claim|Median: $1.71
1.4× median
99442Normal range

Telephone E/M by physician, 11-20 minutes

$5K

192 claims · 0.1%

Your Cost: $28.31/claim|Median: $22.44
1.3× median
69210Top 25%

$5K

134 claims · 0.1%

Your Cost: $35.89/claim|Median: $21.74
1.7× median
96110Normal range

Developmental screening, per standardized instrument

$4K

601 claims · 0.0%

Your Cost: $7.43/claim|Median: $9.10
0.8× median
0001ATop 25%

COVID-19 vaccine admin, Pfizer, 1st dose

$4K

103 claims · 0.0%

Your Cost: $40.79/claim|Median: $33.72
1.2× median
0072ANormal range

$4K

96 claims · 0.0%

Your Cost: $40.75/claim|Median: $39.57
1.0× median
0002ATop 25%

COVID-19 vaccine admin, Pfizer, 2nd dose

$3K

86 claims · 0.0%

Your Cost: $40.67/claim|Median: $36.70
1.1× median
G2010Top 10%

Remote evaluation of patient video/images

$3K

246 claims · 0.0%

Your Cost: $10.35/claim|Median: $3.26
3.2× median
← All providersHow we detect fraud →