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

⚖️ Compare🖨️ Print Report

Provider 1013548866

NPI: 1013548866Share
Active Billing Period:2019-11→2024-11(61 months)

Total Paid

$12.2M

$12,212,046

Total Claims

41K

Beneficiaries

12K

3.4 claims/patient

Avg Cost/Claim

$301

Monthly Spending Trend

Yearly Spending

2019
$3K
+76713%
2020
$2.4M
-5%
2021
$2.2M
+8%
2022
$2.4M
+12%
2023
$2.7M
-10%
2024
$2.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 14 distinct procedure codes. The top code (T2016 (Habilitation, residential, waiver; per diem)) accounts for 65% of total spending.

T2016Top 10%

Habilitation, residential, waiver; per diem

$8.0M

1,753 claims · 65.4%

Your Cost: $4,553.56/claim|Median: $331.94
13.7× median
T2021Normal range

Day habilitation, waiver; per 15 min

$2.9M

19K claims · 23.7%

Your Cost: $152.55/claim|Median: $150.51
1.0× median
T2003Top 25%

Non-emergency transport; encounter/trip

$561K

12K claims · 4.6%

Your Cost: $45.00/claim|Median: $21.70
2.1× median
T2019Normal range

Habilitation, prevocational, waiver; per 15 min

$178K

1,866 claims · 1.5%

Your Cost: $95.19/claim|Median: $88.91
1.1× median
S5130Top 10%

Homemaker service, NOS; per 15 min

$177K

547 claims · 1.4%

Your Cost: $323.49/claim|Median: $48.76
6.6× median
97124Top 5%

$91K

311 claims · 0.7%

Your Cost: $291.57/claim|Median: $17.78
16.4× median
G0176Top 5%

Activity therapy (group), per session

$83K

266 claims · 0.7%

Your Cost: $310.34/claim|Median: $85.09
3.6× median
T2004Normal range

Non-emergency transportation, commercial carrier, encounter trip

$67K

1,393 claims · 0.5%

Your Cost: $47.81/claim|Median: $8.80
5.4× median
T2028Normal range

Specialized supply, NOS; per unit

$58K

1,025 claims · 0.5%

Your Cost: $56.94/claim|Median: $79.30
0.7× median
S5199Top 10%

Personal care item, NOS, each

$51K

539 claims · 0.4%

Your Cost: $95.54/claim|Median: $10.82
8.8× median
T1017Normal range

Targeted case management, per 15 min

$43K

496 claims · 0.4%

Your Cost: $86.28/claim|Median: $69.56
1.2× median
S8940Top 5%

$29K

121 claims · 0.2%

Your Cost: $238.31/claim|Median: $95.40
2.5× median
T2023Normal range

Community transition, waiver; per service

$0

268 claims · 0.0%

Your Cost: $0.00/claim|Median: $300.13
T2034Normal range

Crisis intervention, per 15 min

$0

588 claims · 0.0%

Your Cost: $0.00/claim|Median: $254.45
← All providersHow we detect fraud →