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

Joseph Zappala

Social Worker, Clinical·Chevy Chase, MD·NPI: 1013312834SharePrint ReportML Risk: 84%

Compared to Social Worker, Clinical Peers

Total spending distribution among 34 providers in this specialty

P25MedianP75P90

This provider's total spending of $79K is at the below 25th percentile among 34 Social Worker, Clinical providers.

Total Paid

$79K

$79,258

Total Claims

1,256

Beneficiaries

384

3.3 claims/patient

Avg Cost/Claim

$63

🔍 Analysis

Provider Overview

Joseph Zappala is a Social Worker, Clinical provider based in Chevy Chase, MD. From 2018-01 through 2018-07, this provider received $79K in Medicaid payments across 1K claims serving 384 beneficiaries, billing 2 distinct procedure codes.

Key Findings

  • 📊95% of all billing comes from a single procedure code: 90834 (90834). This extreme concentration is unusual and may indicate specialized services or a narrow billing pattern.
  • 📊Billing stopped in 2018-07, suggesting this provider is no longer active in Medicaid.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 2 distinct procedure codes. The top code (90834 (Psychotherapy, 45 minutes)) accounts for 95% of total spending.

90834Normal range

Psychotherapy, 45 minutes

$76K

1,115 claims · 95.3%

Your Cost: $67.76/claim|Median: $63.65
1.1× median
90853Normal range

Group psychotherapy

$4K

141 claims · 4.7%

Your Cost: $26.28/claim|Median: $25.02
1.1× median