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

Emma Ortega

Counselor·Los Lunas, NM·NPI: 1033354535Share

Compared to Counselor Peers

Total spending distribution among 9 providers in this specialty

P25MedianP75P90

This provider's total spending of $261K is at the below 25th percentile among 9 Counselor providers.

Total Paid

$261K

$261,356

Total Claims

3,279

Beneficiaries

1,418

2.3 claims/patient

Avg Cost/Claim

$80

🔍 Analysis

Provider Overview

Emma Ortega is a Counselor provider based in Los Lunas, NM. From 2018-01 through 2019-05, this provider received $261K in Medicaid payments across 3K claims serving 1K beneficiaries, billing 3 distinct procedure codes.

Key Findings

  • 📊92% of all billing comes from a single procedure code: 90837 (90837). This extreme concentration is unusual and may indicate specialized services or a narrow billing pattern.
  • 📊Billing stopped in 2019-05, suggesting this provider is no longer active in Medicaid. Abrupt cessation of billing can be a risk indicator.

Yearly Spending

2018
$215K
-79%
2019
$46K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 3 distinct procedure codes. The top code (90837 (Psychotherapy, 60 minutes)) accounts for 92% of total spending.

90837Normal range

Psychotherapy, 60 minutes

$242K

3,058 claims · 92.4%

Your Cost: $78.99/claim|Median: $85.66
0.9× median
90791Normal range

Psychiatric diagnostic evaluation

$13K

146 claims · 5.2%

Your Cost: $92.30/claim|Median: $99.21
0.9× median
90847Normal range

Family psychotherapy with patient, 50 min

$6K

75 claims · 2.4%

Your Cost: $84.46/claim|Median: $77.33
1.1× median