Spectrum Health Primary Care Partners
Psychologist, Clinical Child & Adolescent
Grand Rapids, Michigan
NPI: 1235188673
Risk Tier
Elevated
Total Paid
$219.6M
$219,576,485
Total Claims
4.2M
Beneficiaries
3.5M
Avg Cost/Claim
$52.76
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (1)
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 15 procedure codes: 59425 at 7.3× median, 90651 at 6.5× median.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024