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Provider 1972059467

NPI: 1972059467Share
Active Billing Period:2018-02→2024-12(73 months)

Total Paid

$12.0M

$11,955,730

Total Claims

90K

Beneficiaries

51K

1.8 claims/patient

Avg Cost/Claim

$132

Monthly Spending Trend

Yearly Spending

2018
$2K
+35223%
2019
$561K
+170%
2020
$1.5M
+43%
2021
$2.2M
+2%
2022
$2.2M
+18%
2023
$2.6M
+11%
2024
$2.9M

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 28% of total spending.

99213Top 1%

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

$3.4M

17K claims · 28.4%

Your Cost: $203.12/claim|Median: $37.81
5.4× median
99214Top 5%

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

$1.9M

10K claims · 16.2%

Your Cost: $186.14/claim|Median: $53.41
3.5× median
G0467Top 10%

Federally qualified health center visit, mental health

$1.7M

24K claims · 14.0%

Your Cost: $70.56/claim|Median: $21.91
3.2× median
G2025Top 5%

$813K

8,439 claims · 6.8%

Your Cost: $96.28/claim|Median: $15.63
6.2× median
90791Top 5%

Psychiatric diagnostic evaluation

$805K

3,735 claims · 6.7%

Your Cost: $215.52/claim|Median: $99.21
2.2× median
D1110Top 1%

Prophylaxis, adult cleaning

$706K

6,616 claims · 5.9%

Your Cost: $106.78/claim|Median: $43.38
2.5× median
99212Top 5%

Office/outpatient visit, low complexity

$610K

4,286 claims · 5.1%

Your Cost: $142.24/claim|Median: $25.06
5.7× median
90832Top 5%

Psychotherapy, 30 minutes

$591K

3,266 claims · 4.9%

Your Cost: $181.09/claim|Median: $41.28
4.4× median
D0120Top 1%

Periodic oral evaluation, established patient

$355K

3,285 claims · 3.0%

Your Cost: $108.15/claim|Median: $24.34
4.4× median
99396Top 5%

Preventive medicine, established patient, age 40-64

$346K

2,376 claims · 2.9%

Your Cost: $145.72/claim|Median: $76.06
1.9× median
99395Top 5%

Preventive medicine, established patient, age 18-39

$251K

1,532 claims · 2.1%

Your Cost: $163.73/claim|Median: $72.71
2.3× median
G0470Normal range

Chronic care management services, FQHC/RHC

$147K

2,257 claims · 1.2%

Your Cost: $65.12/claim|Median: $45.95
1.4× median
99215Top 10%

Office/outpatient visit, high complexity

$97K

587 claims · 0.8%

Your Cost: $165.08/claim|Median: $74.09
2.2× median
90834Top 5%

Psychotherapy, 45 minutes

$44K

260 claims · 0.4%

Your Cost: $168.31/claim|Median: $63.65
2.6× median
D0150Top 5%

Comprehensive oral evaluation, new or established patient

$40K

529 claims · 0.3%

Your Cost: $76.54/claim|Median: $32.07
2.4× median
92012Top 1%

Ophthalmological exam, intermediate, established patient

$34K

156 claims · 0.3%

Your Cost: $218.53/claim|Median: $38.23
5.7× median
99204Top 5%

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

$29K

168 claims · 0.2%

Your Cost: $175.36/claim|Median: $84.03
2.1× median
92014Top 5%

Ophthalmological exam, comprehensive, established patient

$15K

129 claims · 0.1%

Your Cost: $118.23/claim|Median: $47.08
2.5× median
99202Top 5%

Office/outpatient visit, new patient, low complexity

$11K

74 claims · 0.1%

Your Cost: $143.87/claim|Median: $40.11
3.6× median
99211Top 1%

Office/outpatient visit, minimal complexity

$9K

42 claims · 0.1%

Your Cost: $223.40/claim|Median: $12.93
17.3× median
D0140Top 1%

Limited oral evaluation, problem focused

$8K

42 claims · 0.1%

Your Cost: $181.39/claim|Median: $27.07
6.7× median
93000Top 25%

Electrocardiogram, complete, with interpretation and report

$7K

425 claims · 0.1%

Your Cost: $16.68/claim|Median: $9.70
1.7× median
99205Top 10%

Office/outpatient visit, new patient, high complexity

$7K

32 claims · 0.1%

Your Cost: $206.60/claim|Median: $111.09
1.9× median
90471Normal range

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

$4K

327 claims · 0.0%

Your Cost: $13.12/claim|Median: $9.80
1.3× median
D0330Top 1%

Panoramic radiographic image

$4K

30 claims · 0.0%

Your Cost: $139.76/claim|Median: $37.36
3.7× median
D0191Top 1%

$4K

14 claims · 0.0%

Your Cost: $284.62/claim|Median: $11.16
25.5× median
99397Top 10%

$3K

33 claims · 0.0%

Your Cost: $100.37/claim|Median: $22.92
4.4× median
G0439Top 10%

Annual wellness visit, subsequent visit

$3K

49 claims · 0.0%

Your Cost: $62.08/claim|Median: $5.42
11.5× median
36415Top 5%

Collection of venous blood by venipuncture

$1K

67 claims · 0.0%

Your Cost: $21.74/claim|Median: $1.57
13.8× median
90688Normal range

$1K

102 claims · 0.0%

Your Cost: $12.88/claim|Median: $9.00
1.4× median
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