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

Monique Bautista

Social Worker, Clinical·Fontana, CA·NPI: 1033800560SharePrint ReportML Risk: 83%

Compared to Social Worker, Clinical Peers

Total spending distribution among 34 providers in this specialty

P25MedianP75P90

This provider's total spending of $89K is at the below 25th percentile among 34 Social Worker, Clinical providers.

Total Paid

$89K

$89,452

Total Claims

857

Beneficiaries

270

3.2 claims/patient

Avg Cost/Claim

$104

🔍 Analysis

Provider Overview

Monique Bautista is a Social Worker, Clinical provider based in Fontana, CA. From 2024-05 through 2024-11, this provider received $89K in Medicaid payments across 857 claims serving 270 beneficiaries, billing 2 distinct procedure codes.

Key Findings

  • 📊97% 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.

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 2 distinct procedure codes. The top code (90837 (Psychotherapy, 60 minutes)) accounts for 97% of total spending.

90837Top 25%

Psychotherapy, 60 minutes

$87K

837 claims · 97.0%

Your Cost: $103.70/claim|Median: $85.66
1.2× median
90791Top 25%

Psychiatric diagnostic evaluation

$3K

20 claims · 3.0%

Your Cost: $132.74/claim|Median: $99.21
1.3× median