Total Paid
$98K
$98,330
Total Claims
1,384
Beneficiaries
452
3.1 claims/patient
Avg Cost/Claim
$71
🔍 Analysis
Provider Overview
is a Medicaid provider based in Unknown location. From 2020-03 through 2020-10, this provider received $98K in Medicaid payments across 1K claims serving 452 beneficiaries, billing 3 distinct procedure codes.
Key Findings
- 📊97% of all billing comes from a single procedure code: H2019 (H2019). This extreme concentration is unusual and may indicate specialized services or a narrow billing pattern.
- 📊Billing stopped in 2020-10, suggesting this provider is no longer active in Medicaid. Abrupt cessation of billing can be a risk indicator.
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 3 distinct procedure codes. The top code (H2019 (Therapeutic behavioral services, per 15 min)) accounts for 97% of total spending.
$95K
1,330 claims
$71.67
$84.12
Therapeutic behavioral services, per 15 min
$95K
1,330 claims · 96.9%
$3K
35 claims
$72.06
$80.64
Mental health service plan development
$3K
35 claims · 2.6%
$483
19 claims
$25.42
$96.18
Mental health assessment by non-physician
$483
19 claims · 0.5%