Is CREATIVE COMMUNITY OPTIONS INC flagged for Medicaid fraud?

CREATIVE COMMUNITY OPTIONS INC (NPI: 1023149267) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does CREATIVE COMMUNITY OPTIONS INC bill Medicaid?

CREATIVE COMMUNITY OPTIONS INC received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Day Training/Habilitation Specialist provider. Located in JOHNSTON, IA.

What is NPI 1023149267?

NPI 1023149267 is the National Provider Identifier for CREATIVE COMMUNITY OPTIONS INC. They are a Day Training/Habilitation Specialist provider based in JOHNSTON, IA. This NPI is registered with the CMS NPI Registry.

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CREATIVE COMMUNITY OPTIONS INC

Day Training/Habilitation Specialist·JOHNSTON, IA·NPI: 1023149267Share

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

Total Paid

$41.5M

$41,489,198

Total Claims

170K

Beneficiaries

14K

12.2 claims/patient

Avg Cost/Claim

$244

Monthly Spending Trend

Yearly Spending

2018

$6.6M

+10%

2019

$7.3M

-24%

2020

$5.6M

-1%

2021

$5.5M

-15%

2022

$4.7M

+9%

2023

$5.1M

+30%

2024

$6.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 9 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 69% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H2016Comprehensive community support services, per 15 minSee all providers →

$28.5M

95K claims

$299.73

$321.53

0.9×

Normal range

H2016Normal range

Comprehensive community support services, per 15 min

$28.5M

95K claims · 68.7%

Your Cost: $299.73/claim|Median: $321.53

0.9× median

H2015Comprehensive community support services, per 15 minSee all providers →

$6.6M

45K claims

$145.54

$96.24

1.5×

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

$6.6M

45K claims · 15.9%

Your Cost: $145.54/claim|Median: $96.24

1.5× median

S5136Companion care, adult, per 15 minutesSee all providers →

$3.9M

18K claims

$213.63

$302.34

0.7×

Normal range

S5136Normal range

Companion care, adult, per 15 minutes

$3.9M

18K claims · 9.3%

Your Cost: $213.63/claim|Median: $302.34

0.7× median

H2025Ongoing support to maintain employment, per 15 minSee all providers →

$2.0M

5,780 claims

$345.21

$100.49

3.4×

Top 25%

H2025Top 25%

Ongoing support to maintain employment, per 15 min

$2.0M

5,780 claims · 4.8%

Your Cost: $345.21/claim|Median: $100.49

3.4× median

T2018 See all providers →

$360K

3,070 claims

$117.28

1.0×

Normal range

T2018Normal range

$360K

3,070 claims · 0.9%

Your Cost: $117.28/claim|Median: $117.28

1.0× median

90834Psychotherapy, 45 minutesSee all providers →

$137K

2,169 claims

$63.27

$63.65

1.0×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$137K

2,169 claims · 0.3%

Your Cost: $63.27/claim|Median: $63.65

1.0× median

90853Group psychotherapySee all providers →

$2K

77 claims

$31.38

$25.02

1.3×

Normal range

90853Normal range

Group psychotherapy

$2K

77 claims · 0.0%

Your Cost: $31.38/claim|Median: $25.02

1.3× median

90791Psychiatric diagnostic evaluationSee all providers →

$1K

15 claims

$88.95

$99.21

0.9×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$1K

15 claims · 0.0%

Your Cost: $88.95/claim|Median: $99.21

0.9× median

90832Psychotherapy, 30 minutesSee all providers →

$911

20 claims

$45.57

$41.28

1.1×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$911

20 claims · 0.0%

Your Cost: $45.57/claim|Median: $41.28

1.1× median

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