Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

⚖️ Compare🖨️ Print Report

Provider 1265489736

NPI: 1265489736Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$17.2M

$17,198,149

Total Claims

196K

Beneficiaries

79K

2.5 claims/patient

Avg Cost/Claim

$88

Monthly Spending Trend

Yearly Spending

2018
$1.9M
+24%
2019
$2.4M
-21%
2020
$1.9M
+32%
2021
$2.5M
-4%
2022
$2.4M
+19%
2023
$2.9M
+6%
2024
$3.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (97110 (Therapeutic exercises, each 15 min)) accounts for 31% of total spending.

97110Top 10%

Therapeutic exercises, each 15 min

$5.3M

69K claims · 30.9%

Your Cost: $77.20/claim|Median: $24.49
3.2× median
92507Top 5%

Speech/hearing/language treatment

$3.9M

34K claims · 22.5%

Your Cost: $115.22/claim|Median: $49.45
2.3× median
97530Top 5%

Therapeutic activities, each 15 min

$3.8M

30K claims · 22.3%

Your Cost: $127.70/claim|Median: $33.11
3.9× median
97112Top 10%

Therapeutic procedure, neuromuscular reeducation, per 15 minutes

$1.0M

18K claims · 5.8%

Your Cost: $56.78/claim|Median: $20.04
2.8× median
97162Top 10%

PT evaluation, moderate complexity

$819K

7,368 claims · 4.8%

Your Cost: $111.11/claim|Median: $46.10
2.4× median
97140Top 10%

Manual therapy techniques, per 15 minutes

$789K

19K claims · 4.6%

Your Cost: $41.17/claim|Median: $16.79
2.5× median
J0585Normal range

Injection, onabotulinumtoxinA, 1 unit

$399K

754 claims · 2.3%

Your Cost: $528.90/claim|Median: $470.36
1.1× median
92523Top 5%

Evaluation of speech sound production with language comprehension

$320K

1,024 claims · 1.9%

Your Cost: $312.90/claim|Median: $110.87
2.8× median
97166Top 10%

OT evaluation, moderate complexity

$284K

1,966 claims · 1.7%

Your Cost: $144.49/claim|Median: $48.74
3.0× median
97533Top 25%

$146K

1,538 claims · 0.8%

Your Cost: $94.70/claim|Median: $48.71
1.9× median
97116Top 25%

Gait training

$122K

4,429 claims · 0.7%

Your Cost: $27.65/claim|Median: $12.48
2.2× median
99211Top 10%

Office/outpatient visit, minimal complexity

$110K

2,864 claims · 0.6%

Your Cost: $38.56/claim|Median: $12.93
3.0× median
92526Normal range

Treatment of swallowing dysfunction and/or oral function

$53K

788 claims · 0.3%

Your Cost: $66.63/claim|Median: $49.74
1.3× median
92567Top 5%

$26K

604 claims · 0.2%

Your Cost: $43.42/claim|Median: $11.50
3.8× median
97113Top 25%

$21K

233 claims · 0.1%

Your Cost: $88.34/claim|Median: $51.02
1.7× median
92587Top 10%

$13K

226 claims · 0.1%

Your Cost: $59.13/claim|Median: $19.24
3.1× median
97803Top 25%

Medical nutrition therapy, reassessment, group, thirty minutes

$11K

207 claims · 0.1%

Your Cost: $55.00/claim|Median: $24.33
2.3× median
92579Top 10%

$7K

77 claims · 0.0%

Your Cost: $94.57/claim|Median: $30.58
3.1× median
97542Normal range

Wheelchair management training

$7K

187 claims · 0.0%

Your Cost: $36.89/claim|Median: $18.66
2.0× median
99213Top 10%

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

$7K

82 claims · 0.0%

Your Cost: $83.52/claim|Median: $37.81
2.2× median
97163Top 10%

PT evaluation, high complexity

$6K

48 claims · 0.0%

Your Cost: $125.18/claim|Median: $50.34
2.5× median
97161Normal range

Physical therapy evaluation, low complexity

$5K

93 claims · 0.0%

Your Cost: $57.12/claim|Median: $47.89
1.2× median
G0463Normal range

Hospital outpatient clinic visit

$4K

2,026 claims · 0.0%

Your Cost: $2.18/claim|Median: $26.41
0.1× median
99215Top 10%

Office/outpatient visit, high complexity

$4K

25 claims · 0.0%

Your Cost: $153.85/claim|Median: $74.09
2.1× median
95874Normal range

$3K

124 claims · 0.0%

Your Cost: $23.40/claim|Median: $11.29
2.1× median
64642Normal range

$3K

77 claims · 0.0%

Your Cost: $37.65/claim|Median: $81.85
0.5× median
97535Top 25%

Self-care/home management training, per 15 minutes

$3K

72 claims · 0.0%

Your Cost: $37.19/claim|Median: $18.18
2.0× median
97802Top 5%

Medical nutrition therapy, reassessment, individual, fifteen minutes

$2K

14 claims · 0.0%

Your Cost: $155.84/claim|Median: $12.70
12.3× median
97035Top 25%

Ultrasound therapy

$2K

95 claims · 0.0%

Your Cost: $16.29/claim|Median: $7.31
2.2× median
97760Top 5%

$1K

12 claims · 0.0%

Your Cost: $97.74/claim|Median: $30.29
3.2× median
← All providersHow we detect fraud →