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

⚖️ Compare🖨️ Print Report

Provider 1043260243

NPI: 1043260243Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$11.2M

$11,230,721

Total Claims

126K

Beneficiaries

77K

1.6 claims/patient

Avg Cost/Claim

$89

Monthly Spending Trend

Yearly Spending

2018
$4.0M
-2%
2019
$3.9M
-59%
2020
$1.6M
-77%
2021
$358K
+10%
2022
$396K
+54%
2023
$608K
-32%
2024
$413K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (90834 (Psychotherapy, 45 minutes)) accounts for 22% of total spending.

90834Normal range

Psychotherapy, 45 minutes

$2.5M

36K claims · 22.3%

Your Cost: $69.42/claim|Median: $63.65
1.1× median
H2014Top 25%

Skills training & development, per 15 min

$2.4M

11K claims · 21.8%

Your Cost: $212.66/claim|Median: $83.88
2.5× median
90837Top 10%

Psychotherapy, 60 minutes

$1.3M

8,799 claims · 11.3%

Your Cost: $143.94/claim|Median: $85.66
1.7× median
99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$1.2M

20K claims · 10.8%

Your Cost: $61.12/claim|Median: $53.41
1.1× median
H0017Normal range

$698K

900 claims · 6.2%

Your Cost: $775.46/claim|Median: $470.95
1.6× median
90791Normal range

Psychiatric diagnostic evaluation

$662K

6,027 claims · 5.9%

Your Cost: $109.81/claim|Median: $99.21
1.1× median
90832Normal range

Psychotherapy, 30 minutes

$374K

9,385 claims · 3.3%

Your Cost: $39.86/claim|Median: $41.28
1.0× median
T1017Normal range

Targeted case management, per 15 min

$372K

5,600 claims · 3.3%

Your Cost: $66.48/claim|Median: $69.56
1.0× median
H2011Normal range

Crisis intervention service, per 15 minutes

$263K

1,567 claims · 2.3%

Your Cost: $168.08/claim|Median: $215.80
0.8× median
90847Top 10%

Family psychotherapy with patient, 50 min

$226K

1,461 claims · 2.0%

Your Cost: $154.89/claim|Median: $77.33
2.0× median
H0004Normal range

Behavioral health counseling & therapy, per 15 min

$166K

1,676 claims · 1.5%

Your Cost: $98.92/claim|Median: $74.63
1.3× median
H0002Normal range

Behavioral health screening

$137K

2,651 claims · 1.2%

Your Cost: $51.71/claim|Median: $38.77
1.3× median
H0038Top 25%

Self-help/peer services, per 15 minutes

$114K

1,019 claims · 1.0%

Your Cost: $111.61/claim|Median: $55.04
2.0× median
H0023Normal range

Behavioral health outreach service, per 15 minutes

$101K

2,246 claims · 0.9%

Your Cost: $44.88/claim|Median: $53.97
0.8× median
H0034Normal range

Medication training and management, per 15 min

$95K

1,933 claims · 0.8%

Your Cost: $49.07/claim|Median: $56.90
0.9× median
H0005Top 10%

Alcohol and/or drug services, group counseling

$95K

1,258 claims · 0.8%

Your Cost: $75.34/claim|Median: $47.35
1.6× median
H0039Top 25%

Assertive community treatment, per diem

$75K

265 claims · 0.7%

Your Cost: $282.84/claim|Median: $132.62
2.1× median
90785Top 5%

$65K

4,334 claims · 0.6%

Your Cost: $14.99/claim|Median: $6.43
2.3× median
H0032Normal range

Mental health service plan development

$54K

1,816 claims · 0.5%

Your Cost: $29.65/claim|Median: $80.64
0.4× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$44K

435 claims · 0.4%

Your Cost: $101.12/claim|Median: $108.91
0.9× median
90853Normal range

Group psychotherapy

$44K

3,973 claims · 0.4%

Your Cost: $11.04/claim|Median: $25.02
0.4× median
H0031Normal range

Mental health assessment by non-physician

$33K

422 claims · 0.3%

Your Cost: $79.02/claim|Median: $96.18
0.8× median
J2426Top 25%

$33K

16 claims · 0.3%

Your Cost: $2,056.28/claim|Median: $625.59
3.3× median
90846Top 10%

Family psychotherapy without patient, 50 min

$32K

243 claims · 0.3%

Your Cost: $132.14/claim|Median: $76.61
1.7× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$27K

857 claims · 0.2%

Your Cost: $31.03/claim|Median: $37.81
0.8× median
99215Normal range

Office/outpatient visit, high complexity

$26K

287 claims · 0.2%

Your Cost: $90.61/claim|Median: $74.09
1.2× median
H0025Normal range

Behavioral health prevention education, per session

$12K

571 claims · 0.1%

Your Cost: $20.29/claim|Median: $36.25
0.6× median
H2030Normal range

Mental health clubhouse services, per 15 minutes

$10K

259 claims · 0.1%

Your Cost: $38.14/claim|Median: $73.58
0.5× median
H0001Top 10%

Alcohol and/or drug assessment

$10K

48 claims · 0.1%

Your Cost: $197.93/claim|Median: $94.22
2.1× median
99204Top 25%

Office/outpatient visit, new patient, mod-high complexity

$8K

64 claims · 0.1%

Your Cost: $120.09/claim|Median: $84.03
1.4× median
← All providersHow we detect fraud →