Is PARAGON CONTRACTING SERVICES LLC flagged for Medicaid fraud?

PARAGON CONTRACTING SERVICES LLC (NPI: 1225071459) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does PARAGON CONTRACTING SERVICES LLC bill Medicaid?

PARAGON CONTRACTING SERVICES LLC received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Emergency Medicine provider. Located in BIRMINGHAM, AL.

What is NPI 1225071459?

NPI 1225071459 is the National Provider Identifier for PARAGON CONTRACTING SERVICES LLC. They are a Emergency Medicine provider based in BIRMINGHAM, AL. This NPI is registered with the CMS NPI Registry.

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PARAGON CONTRACTING SERVICES LLC

Emergency Medicine·BIRMINGHAM, AL·NPI: 1225071459Share

Compared to Emergency Medicine Peers

Total spending distribution among 11 providers in this specialty

P25MedianP75P90

This provider's total spending of $54.5M is at the 50th percentile among 11 Emergency Medicine providers.

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

Total Paid

$54.5M

$54,465,969

Total Claims

1.1M

Beneficiaries

879K

1.3 claims/patient

Avg Cost/Claim

$49

Monthly Spending Trend

Yearly Spending

2018

$3.7M

+155%

2019

$9.5M

-29%

2020

$6.8M

+39%

2021

$9.5M

+2%

2022

$9.7M

+10%

2023

$10.6M

-56%

2024

$4.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (99285 (Emergency dept visit, high/urgent complexity)) accounts for 47% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

99285Emergency dept visit, high/urgent complexitySee all providers →

$25.8M

429K claims

$60.05

$85.65

0.7×

Normal range

99285Normal range

Emergency dept visit, high/urgent complexity

$25.8M

429K claims · 47.3%

Your Cost: $60.05/claim|Median: $85.65

0.7× median

99284Emergency dept visit, high complexitySee all providers →

$20.6M

397K claims

$51.94

$69.51

0.7×

Normal range

99284Normal range

Emergency dept visit, high complexity

$20.6M

397K claims · 37.9%

Your Cost: $51.94/claim|Median: $69.51

0.7× median

99283Emergency dept visit, moderate complexitySee all providers →

$7.5M

205K claims

$36.73

$42.48

0.9×

Normal range

99283Normal range

Emergency dept visit, moderate complexity

$7.5M

205K claims · 13.9%

Your Cost: $36.73/claim|Median: $42.48

0.9× median

99291Critical care, first 30-74 minutesSee all providers →

$448K

5,776 claims

$77.50

$101.24

0.8×

Normal range

99291Normal range

Critical care, first 30-74 minutes

$448K

5,776 claims · 0.8%

Your Cost: $77.50/claim|Median: $101.24

0.8× median

93010Electrocardiogram, interpretation and report onlySee all providers →

$57K

20K claims

$2.80

$5.60

0.5×

Normal range

93010Normal range

Electrocardiogram, interpretation and report only

$57K

20K claims · 0.1%

Your Cost: $2.80/claim|Median: $5.60

0.5× median

99282Emergency dept visit, low complexitySee all providers →

$5K

173 claims

$27.78

$37.72

0.7×

Normal range

99282Normal range

Emergency dept visit, low complexity

$5K

173 claims · 0.0%

Your Cost: $27.78/claim|Median: $37.72

0.7× median

99220 See all providers →

$4K

29 claims

$125.21

$73.56

1.7×

Top 25%

99220Top 25%

$4K

29 claims · 0.0%

Your Cost: $125.21/claim|Median: $73.56

1.7× median

99217 See all providers →

$1K

94 claims

$14.41

$31.89

0.5×

Normal range

99217Normal range

$1K

94 claims · 0.0%

Your Cost: $14.41/claim|Median: $31.89

0.5× median

99053 See all providers →

$619

57K claims

$0.01

$0.38

0.0×

Normal range

99053Normal range

$619

57K claims · 0.0%

Your Cost: $0.01/claim|Median: $0.38

0.0× median

99292 See all providers →

$474

39 claims

$12.16

$57.64

0.2×

Normal range

99292Normal range

$474

39 claims · 0.0%

Your Cost: $12.16/claim|Median: $57.64

0.2× median

99407 See all providers →

$404

176 claims

$2.29

$13.29

0.2×

Normal range

99407Normal range

$404

176 claims · 0.0%

Your Cost: $2.29/claim|Median: $13.29

0.2× median

99406 See all providers →

$148

60 claims

$2.46

$6.53

0.4×

Normal range

99406Normal range

$148

60 claims · 0.0%

Your Cost: $2.46/claim|Median: $6.53

0.4× median

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