Is Provider 1194099127 flagged for Medicaid fraud?

Provider 1194099127 (NPI: 1194099127) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does Provider 1194099127 bill Medicaid?

Provider 1194099127 received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records.

What is NPI 1194099127?

NPI 1194099127 is the National Provider Identifier for Provider 1194099127.. This NPI is registered with the CMS NPI Registry.

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Provider 1194099127

NPI: 1194099127Share

Active Billing Period:2018-01→2024-10(82 months)

Total Paid

$14.5M

$14,510,784

Total Claims

183K

Beneficiaries

59K

3.1 claims/patient

Avg Cost/Claim

$79

Monthly Spending Trend

Yearly Spending

2018

$1.5M

-61%

2019

$574K

+88%

2020

$1.1M

-37%

2021

$676K

+54%

2022

$1.0M

+328%

2023

$4.4M

+18%

2024

$5.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (G0299 (Skilled nursing services, home health, per visit, RN)) accounts for 57% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

G0299Skilled nursing services, home health, per visit, RNSee all providers →

$8.3M

81K claims

$101.96

$51.67

2.0×

Top 25%

G0299Top 25%

Skilled nursing services, home health, per visit, RN

$8.3M

81K claims · 56.9%

Your Cost: $101.96/claim|Median: $51.67

2.0× median

T1031Nursing care, in the home, by LPN, per diemSee all providers →

$2.3M

29K claims

$77.10

$80.56

1.0×

Normal range

T1031Normal range

Nursing care, in the home, by LPN, per diem

$2.3M

29K claims · 15.6%

Your Cost: $77.10/claim|Median: $80.56

1.0× median

G0151Physical therapy services, home health, per visitSee all providers →

$947K

10K claims

$93.58

$67.94

1.4×

Normal range

G0151Normal range

Physical therapy services, home health, per visit

$947K

10K claims · 6.5%

Your Cost: $93.58/claim|Median: $67.94

1.4× median

G0157Services of PT assistant in home health, per 15 minSee all providers →

$568K

7,167 claims

$79.32

$43.94

1.8×

Normal range

G0157Normal range

Services of PT assistant in home health, per 15 min

$568K

7,167 claims · 3.9%

Your Cost: $79.32/claim|Median: $43.94

1.8× median

T1030Nursing care, in the home, by RN, per diemSee all providers →

$409K

4,410 claims

$92.82

$85.62

1.1×

Normal range

T1030Normal range

Nursing care, in the home, by RN, per diem

$409K

4,410 claims · 2.8%

Your Cost: $92.82/claim|Median: $85.62

1.1× median

S9131Physical therapy, in the home, per diemSee all providers →

$348K

3,741 claims

$93.01

$90.35

1.0×

Normal range

S9131Normal range

Physical therapy, in the home, per diem

$348K

3,741 claims · 2.4%

Your Cost: $93.01/claim|Median: $90.35

1.0× median

G0300Skilled nursing services, home health, per visit, LPNSee all providers →

$347K

1,518 claims

$228.55

$45.50

5.0×

Top 10%

G0300Top 10%

Skilled nursing services, home health, per visit, LPN

$347K

1,518 claims · 2.4%

Your Cost: $228.55/claim|Median: $45.50

5.0× median

T1001Nursing assessment/evaluation, per visitSee all providers →

$329K

3,376 claims

$97.42

$49.05

2.0×

Top 25%

T1001Top 25%

Nursing assessment/evaluation, per visit

$329K

3,376 claims · 2.3%

Your Cost: $97.42/claim|Median: $49.05

2.0× median

G0152Occupational therapy services, home health, per visitSee all providers →

$284K

2,596 claims

$109.24

$68.93

1.6×

Top 25%

G0152Top 25%

Occupational therapy services, home health, per visit

$284K

2,596 claims · 2.0%

Your Cost: $109.24/claim|Median: $68.93

1.6× median

97163PT evaluation, high complexitySee all providers →

$235K

2,757 claims

$85.33

$50.34

1.7×

Top 25%

97163Top 25%

PT evaluation, high complexity

$235K

2,757 claims · 1.6%

Your Cost: $85.33/claim|Median: $50.34

1.7× median

G0156Home health aide services, per visitSee all providers →

$133K

3,596 claims

$36.96

$39.42

0.9×

Normal range

G0156Normal range

Home health aide services, per visit

$133K

3,596 claims · 0.9%

Your Cost: $36.96/claim|Median: $39.42

0.9× median

G0158Services of OT assistant in home health, per 15 minSee all providers →

$128K

1,471 claims

$87.04

$52.84

1.6×

Normal range

G0158Normal range

Services of OT assistant in home health, per 15 min

$128K

1,471 claims · 0.9%

Your Cost: $87.04/claim|Median: $52.84

1.6× median

S9129OT, in the home, per diemSee all providers →

$69K

639 claims

$107.20

$76.61

1.4×

Top 25%

S9129Top 25%

OT, in the home, per diem

$69K

639 claims · 0.5%

Your Cost: $107.20/claim|Median: $76.61

1.4× median

97167OT evaluation, high complexitySee all providers →

$67K

629 claims

$106.39

$70.96

1.5×

Normal range

97167Normal range

OT evaluation, high complexity

$67K

629 claims · 0.5%

Your Cost: $106.39/claim|Median: $70.96

1.5× median

G0155Services of clinical social worker in home health, per 15 minSee all providers →

$39K

360 claims

$108.83

$7.04

15.5×

Top 25%

G0155Top 25%

Services of clinical social worker in home health, per 15 min

$39K

360 claims · 0.3%

Your Cost: $108.83/claim|Median: $7.04

15.5× median

G0162Skilled services by RN in home health, per 15 minSee all providers →

$39K

1,398 claims

$28.01

$59.83

0.5×

Normal range

G0162Normal range

Skilled services by RN in home health, per 15 min

$39K

1,398 claims · 0.3%

Your Cost: $28.01/claim|Median: $59.83

0.5× median

T1021Home health aide visit, per 15 minSee all providers →

$23K

480 claims

$47.99

$44.79

1.1×

Normal range

T1021Normal range

Home health aide visit, per 15 min

$23K

480 claims · 0.2%

Your Cost: $47.99/claim|Median: $44.79

1.1× median

G0159Services of clinical social worker in home health, per 15 minSee all providers →

$4K

123 claims

$34.63

$60.00

0.6×

Normal range

G0159Normal range

Services of clinical social worker in home health, per 15 min

$4K

123 claims · 0.0%

Your Cost: $34.63/claim|Median: $60.00

0.6× median

0551 See all providers →

$4K

569 claims

$7.46

$2.10

3.6×

Normal range

0551Normal range

$4K

569 claims · 0.0%

Your Cost: $7.46/claim|Median: $2.10

3.6× median

G0153Services of SLP in home health, per 15 minSee all providers →

$3K

28 claims

$113.12

$101.43

1.1×

Normal range

G0153Normal range

Services of SLP in home health, per 15 min

$3K

28 claims · 0.0%

Your Cost: $113.12/claim|Median: $101.43

1.1× median

92524Behavioral/qualitative analysis of voiceSee all providers →

$2K

13 claims

$119.23

$29.36

4.1×

Top 5%

92524Top 5%

Behavioral/qualitative analysis of voice

$2K

13 claims · 0.0%

Your Cost: $119.23/claim|Median: $29.36

4.1× median

3HA11 See all providers →

$1K

489 claims

$2.73

1.0×

Normal range

3HA11Normal range

$1K

489 claims · 0.0%

Your Cost: $2.73/claim|Median: $2.73

1.0× median

G0160 See all providers →

$720

13 claims

$55.38

$95.10

0.6×

Normal range

G0160Normal range

$720

13 claims · 0.0%

Your Cost: $55.38/claim|Median: $95.10

0.6× median

0424 See all providers →

$165

138 claims

$1.20

$14.82

0.1×

Normal range

0424Normal range

$165

138 claims · 0.0%

Your Cost: $1.20/claim|Median: $14.82

0.1× median

Q5001Injection, filgrastim-sndz, biosimilar, 1 mcgSee all providers →

17K claims

$0.00

$23.43

0.0×

Normal range

Q5001Normal range

Injection, filgrastim-sndz, biosimilar, 1 mcg

17K claims · 0.0%

Your Cost: $0.00/claim|Median: $23.43

0.0× median

3JA11 See all providers →

281 claims

$0.00

—

3JA11

281 claims · 0.0%

1CA11 See all providers →

12 claims

$0.00

—

1CA11

12 claims · 0.0%

3AC11 See all providers →

107 claims

$0.00

—

3AC11

107 claims · 0.0%

3LA11 See all providers →

218 claims

$0.00

—

3LA11

218 claims · 0.0%

3BA11 See all providers →

627 claims

$0.00

—

3BA11

627 claims · 0.0%

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