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

⚖️ Compare🖨️ Print Report

Provider 1265656458

NPI: 1265656458Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$7.7M

$7,710,039

Total Claims

72K

Beneficiaries

29K

2.5 claims/patient

Avg Cost/Claim

$108

Monthly Spending Trend

Yearly Spending

2018
$688K
+31%
2019
$901K
+59%
2020
$1.4M
-7%
2021
$1.3M
-12%
2022
$1.2M
-0%
2023
$1.2M
-17%
2024
$983K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 8 distinct procedure codes. The top code (T1016 (Case management, each 15 min)) accounts for 73% of total spending.

T1016Top 25%

Case management, each 15 min

$5.6M

50K claims · 72.7%

Your Cost: $110.92/claim|Median: $49.62
2.2× median
T2041Normal range

Supports brokerage, self-directed; per 15 min

$1.9M

16K claims · 24.3%

Your Cost: $115.96/claim|Median: $162.29
0.7× median
B4150Normal range

Enteral formula, nutritionally complete with fiber, per 100 calories

$83K

1,221 claims · 1.1%

Your Cost: $68.31/claim|Median: $89.79
0.8× median
B4154Normal range

$58K

807 claims · 0.8%

Your Cost: $72.00/claim|Median: $132.96
0.5× median
S5161Normal range

Emergency response system, per month

$43K

1,809 claims · 0.6%

Your Cost: $23.67/claim|Median: $29.97
0.8× median
T4535Normal range

Adult-sized disposable underpads/pads, large

$27K

753 claims · 0.4%

Your Cost: $36.39/claim|Median: $42.03
0.9× median
B4152Normal range

Enteral formula, calorically dense, per 100 calories

$25K

300 claims · 0.3%

Your Cost: $84.27/claim|Median: $92.20
0.9× median
99199Normal range

Unlisted special service, procedure, or report

$1K

194 claims · 0.0%

Your Cost: $5.49/claim|Median: $5.39
1.0× median
← All providersHow we detect fraud →