Is Provider 1043563257 flagged for Medicaid fraud?

Provider 1043563257 (NPI: 1043563257) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does Provider 1043563257 bill Medicaid?

Provider 1043563257 received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records.

What is NPI 1043563257?

NPI 1043563257 is the National Provider Identifier for Provider 1043563257.. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

Provider 1043563257

NPI: 1043563257Share

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

Total Paid

$8.9M

$8,882,405

Total Claims

170K

Beneficiaries

59K

2.9 claims/patient

Avg Cost/Claim

$52

Monthly Spending Trend

Yearly Spending

2018

$537K

+64%

2019

$883K

+11%

2020

$982K

+54%

2021

$1.5M

+24%

2022

$1.9M

+25%

2023

$2.3M

-67%

2024

$764K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 15 distinct procedure codes. The top code (97110 (Therapeutic exercises, each 15 min)) accounts for 89% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

97110Therapeutic exercises, each 15 minSee all providers →

$7.9M

120K claims

$65.68

$24.49

2.7×

Top 10%

97110Top 10%

Therapeutic exercises, each 15 min

$7.9M

120K claims · 88.5%

Your Cost: $65.68/claim|Median: $24.49

2.7× median

97163PT evaluation, high complexitySee all providers →

$729K

10K claims

$70.33

$50.34

1.4×

Normal range

97163Normal range

PT evaluation, high complexity

$729K

10K claims · 8.2%

Your Cost: $70.33/claim|Median: $50.34

1.4× median

97530Therapeutic activities, each 15 minSee all providers →

$117K

4,157 claims

$28.15

$33.11

0.9×

Normal range

97530Normal range

Therapeutic activities, each 15 min

$117K

4,157 claims · 1.3%

Your Cost: $28.15/claim|Median: $33.11

0.9× median

97112Therapeutic procedure, neuromuscular reeducation, per 15 minutesSee all providers →

$56K

14K claims

$3.93

$20.04

0.2×

Normal range

97112Normal range

Therapeutic procedure, neuromuscular reeducation, per 15 minutes

$56K

14K claims · 0.6%

Your Cost: $3.93/claim|Median: $20.04

0.2× median

97161Physical therapy evaluation, low complexitySee all providers →

$52K

2,305 claims

$22.75

$47.89

0.5×

Normal range

97161Normal range

Physical therapy evaluation, low complexity

$52K

2,305 claims · 0.6%

Your Cost: $22.75/claim|Median: $47.89

0.5× median

97140Manual therapy techniques, per 15 minutesSee all providers →

$46K

16K claims

$2.80

$16.79

0.2×

Normal range

97140Normal range

Manual therapy techniques, per 15 minutes

$46K

16K claims · 0.5%

Your Cost: $2.80/claim|Median: $16.79

0.2× median

97162PT evaluation, moderate complexitySee all providers →

$19K

765 claims

$25.37

$46.10

0.6×

Normal range

97162Normal range

PT evaluation, moderate complexity

$19K

765 claims · 0.2%

Your Cost: $25.37/claim|Median: $46.10

0.6× median

97014Electrical stimulation, unattendedSee all providers →

$293

46 claims

$6.36

$8.83

0.7×

Normal range

97014Normal range

Electrical stimulation, unattended

$293

46 claims · 0.0%

Your Cost: $6.36/claim|Median: $8.83

0.7× median

G0283 See all providers →

$112

250 claims

$0.45

$3.52

0.1×

Normal range

G0283Normal range

$112

250 claims · 0.0%

Your Cost: $0.45/claim|Median: $3.52

0.1× median

G8979 See all providers →

814 claims

$0.00

$3.96

—

Normal range

G8979Normal range

814 claims · 0.0%

Your Cost: $0.00/claim|Median: $3.96

G8980 See all providers →

98 claims

$0.00

$0.84

—

Normal range

G8980Normal range

98 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.84

G8984 See all providers →

121 claims

$0.00

$0.30

—

Normal range

G8984Normal range

121 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.30

G8978 See all providers →

635 claims

$0.00

$5.17

—

Normal range

G8978Normal range

635 claims · 0.0%

Your Cost: $0.00/claim|Median: $5.17

G8982 See all providers →

22 claims

$0.00

$6.66

—

Normal range

G8982Normal range

22 claims · 0.0%

Your Cost: $0.00/claim|Median: $6.66

G8985 See all providers →

210 claims

$0.00

$0.25

—

Normal range

G8985Normal range

210 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.25

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