Is RESOLUTIONCARE, PC flagged for Medicaid fraud?

RESOLUTIONCARE, PC (NPI: 1194121681) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does RESOLUTIONCARE, PC bill Medicaid?

RESOLUTIONCARE, PC received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Specialist provider. Located in SAN MATEO, CA.

What is NPI 1194121681?

NPI 1194121681 is the National Provider Identifier for RESOLUTIONCARE, PC. They are a Specialist provider based in SAN MATEO, CA. This NPI is registered with the CMS NPI Registry.

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RESOLUTIONCARE, PC

Specialist·SAN MATEO, CA·NPI: 1194121681Share

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

Total Paid

$27.1M

$27,135,422

Total Claims

69K

Beneficiaries

44K

1.6 claims/patient

Avg Cost/Claim

$393

Monthly Spending Trend

Yearly Spending

2018

$1.5M

+17%

2019

$1.8M

+12%

2020

$2.0M

+24%

2021

$2.5M

+72%

2022

$4.3M

+24%

2023

$5.3M

+84%

2024

$9.8M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (T2025 (Waiver services, NOS; per 15 min)) accounts for 62% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T2025Waiver services, NOS; per 15 minSee all providers →

$16.9M

27K claims

$626.08

$124.39

5.0×

Top 25%

T2025Top 25%

Waiver services, NOS; per 15 min

$16.9M

27K claims · 62.3%

Your Cost: $626.08/claim|Median: $124.39

5.0× median

G9012Other specified case management service, per 15 minutesSee all providers →

$8.9M

33K claims

$267.77

$137.85

1.9×

Top 25%

G9012Top 25%

Other specified case management service, per 15 minutes

$8.9M

33K claims · 32.9%

Your Cost: $267.77/claim|Median: $137.85

1.9× median

T2024Supported employment, waiver, per diemSee all providers →

$778K

1,254 claims

$620.14

$259.38

2.4×

Top 25%

T2024Top 25%

Supported employment, waiver, per diem

$778K

1,254 claims · 2.9%

Your Cost: $620.14/claim|Median: $259.38

2.4× median

99487 See all providers →

$172K

1,776 claims

$96.62

$14.74

6.6×

Top 5%

99487Top 5%

$172K

1,776 claims · 0.6%

Your Cost: $96.62/claim|Median: $14.74

6.6× median

99489 See all providers →

$147K

1,257 claims

$116.96

$9.86

11.9×

Top 5%

99489Top 5%

$147K

1,257 claims · 0.5%

Your Cost: $116.96/claim|Median: $9.86

11.9× median

99499Unlisted evaluation and management serviceSee all providers →

$88K

2,246 claims

$39.05

$30.88

1.3×

Normal range

99499Normal range

Unlisted evaluation and management service

$88K

2,246 claims · 0.3%

Your Cost: $39.05/claim|Median: $30.88

1.3× median

99215Office/outpatient visit, high complexitySee all providers →

$71K

860 claims

$82.96

$74.09

1.1×

Normal range

99215Normal range

Office/outpatient visit, high complexity

$71K

860 claims · 0.3%

Your Cost: $82.96/claim|Median: $74.09

1.1× median

G9008Coordination of long-term care services, per monthSee all providers →

$14K

141 claims

$102.19

$66.78

1.5×

Normal range

G9008Normal range

Coordination of long-term care services, per month

$14K

141 claims · 0.1%

Your Cost: $102.19/claim|Median: $66.78

1.5× median

T1014 See all providers →

$12K

945 claims

$12.38

$12.88

1.0×

Normal range

T1014Normal range

$12K

945 claims · 0.0%

Your Cost: $12.38/claim|Median: $12.88

1.0× median

99214Office/outpatient visit, est. patient, mod-high complexitySee all providers →

$653

12 claims

$54.38

$53.41

1.0×

Normal range

99214Normal range

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

$653

12 claims · 0.0%

Your Cost: $54.38/claim|Median: $53.41

1.0× median

G2211 See all providers →

$279

88 claims

$3.17

$2.40

1.3×

Normal range

G2211Normal range

$279

88 claims · 0.0%

Your Cost: $3.17/claim|Median: $2.40

1.3× median

99350 See all providers →

$116

31 claims

$3.75

$35.62

0.1×

Normal range

99350Normal range

$116

31 claims · 0.0%

Your Cost: $3.75/claim|Median: $35.62

0.1× median

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