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

⚖️ Compare🖨️ Print Report

Provider 1285954339

NPI: 1285954339Share
Active Billing Period:2018-01→2024-12(74 months)

Total Paid

$12.3M

$12,296,142

Total Claims

245K

Beneficiaries

39K

6.2 claims/patient

Avg Cost/Claim

$50

Monthly Spending Trend

Yearly Spending

2018
$1.9M
+23%
2019
$2.3M
-78%
2020
$497K
+152%
2021
$1.3M
+58%
2022
$2.0M
+15%
2023
$2.3M
-6%
2024
$2.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 24 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 54% of total spending.

T1015Normal range

Clinic visit/encounter, all-inclusive

$6.7M

102K claims · 54.2%

Your Cost: $65.50/claim|Median: $121.16
0.5× median
97530Normal range

Therapeutic activities, each 15 min

$1.4M

35K claims · 11.7%

Your Cost: $41.43/claim|Median: $33.11
1.3× median
92507Normal range

Speech/hearing/language treatment

$1.3M

22K claims · 10.5%

Your Cost: $57.65/claim|Median: $49.45
1.2× median
97110Top 25%

Therapeutic exercises, each 15 min

$1.2M

23K claims · 9.9%

Your Cost: $52.04/claim|Median: $24.49
2.1× median
A0120Normal range

Non-emergency mini-bus transport

$962K

37K claims · 7.8%

Your Cost: $26.05/claim|Median: $16.09
1.6× median
97535Normal range

Self-care/home management training, per 15 minutes

$256K

9,076 claims · 2.1%

Your Cost: $28.24/claim|Median: $18.18
1.6× median
97532Normal range

$227K

8,961 claims · 1.8%

Your Cost: $25.34/claim|Median: $28.76
0.9× median
97161Top 25%

Physical therapy evaluation, low complexity

$32K

335 claims · 0.3%

Your Cost: $94.16/claim|Median: $47.89
2.0× median
97150Normal range

Therapeutic procedure, group (2+ patients)

$24K

2,724 claims · 0.2%

Your Cost: $8.87/claim|Median: $12.12
0.7× median
96112Normal range

Developmental test administration

$24K

247 claims · 0.2%

Your Cost: $95.32/claim|Median: $102.95
0.9× median
92508Normal range

Treatment of speech/language disorder, group, 2+ patients

$19K

1,450 claims · 0.2%

Your Cost: $13.30/claim|Median: $13.22
1.0× median
97165Top 25%

OT evaluation, low complexity

$17K

185 claims · 0.1%

Your Cost: $92.47/claim|Median: $46.78
2.0× median
99367Normal range

$16K

502 claims · 0.1%

Your Cost: $32.78/claim|Median: $35.65
0.9× median
97001Top 25%

$16K

167 claims · 0.1%

Your Cost: $95.92/claim|Median: $50.40
1.9× median
92523Normal range

Evaluation of speech sound production with language comprehension

$16K

212 claims · 0.1%

Your Cost: $74.16/claim|Median: $110.87
0.7× median
T1023Normal range

Screening to determine appropriateness of consideration for program

$15K

205 claims · 0.1%

Your Cost: $74.81/claim|Median: $106.70
0.7× median
G0515Normal range

$13K

608 claims · 0.1%

Your Cost: $20.60/claim|Median: $23.57
0.9× median
97003Normal range

$12K

135 claims · 0.1%

Your Cost: $90.82/claim|Median: $98.97
0.9× median
96113Normal range

Developmental test admin, each additional 30 min

$11K

156 claims · 0.1%

Your Cost: $69.23/claim|Median: $77.06
0.9× median
97166Top 10%

OT evaluation, moderate complexity

$4K

29 claims · 0.0%

Your Cost: $143.21/claim|Median: $48.74
2.9× median
90887Top 25%

Interpretation/explanation of results

$3K

39 claims · 0.0%

Your Cost: $79.02/claim|Median: $47.55
1.7× median
92587Top 10%

$2K

33 claims · 0.0%

Your Cost: $67.24/claim|Median: $19.24
3.5× median
90791Normal range

Psychiatric diagnostic evaluation

$864

17 claims · 0.0%

Your Cost: $50.82/claim|Median: $99.21
0.5× median
T1027Normal range

Family training and counseling, per 15 minutes

$300

42 claims · 0.0%

Your Cost: $7.14/claim|Median: $53.00
0.1× median
← All providersHow we detect fraud →