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Unknown Provider 1073512950

NPI: 1073512950SharePrint ReportML Risk: 83%

Total Paid

$11K

$11,227

Total Claims

905

Beneficiaries

835

1.1 claims/patient

Avg Cost/Claim

$12

🔍 Analysis

Provider Overview

is a Medicaid provider based in Unknown location. From 2018-01 through 2018-07, this provider received $11K in Medicaid payments across 905 claims serving 835 beneficiaries, billing 4 distinct procedure codes.

Key Findings

  • 📊Billing stopped in 2018-07, suggesting this provider is no longer active in Medicaid. Abrupt cessation of billing can be a risk indicator.

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 4 distinct procedure codes. The top code (99212 (Office/outpatient visit, low complexity)) accounts for 58% of total spending.

99212Normal range

Office/outpatient visit, low complexity

$6K

698 claims · 57.7%

Your Cost: $9.27/claim|Median: $25.06
0.4× median
99396Normal range

Preventive medicine, established patient, age 40-64

$4K

138 claims · 35.3%

Your Cost: $28.71/claim|Median: $76.06
0.4× median
99213Normal range

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

$696

33 claims · 6.2%

Your Cost: $21.08/claim|Median: $37.81
0.6× median
36415Top 25%

Collection of venous blood by venipuncture

$96

36 claims · 0.9%

Your Cost: $2.67/claim|Median: $1.57
1.7× median