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

⚖️ Compare🖨️ Print Report

Provider 1285979757

NPI: 1285979757Share
Active Billing Period:2018-01→2024-04(69 months)
Billing appears to have stoppedLast active: 2024-04

Total Paid

$8.7M

$8,701,305

Total Claims

114K

Beneficiaries

40K

2.8 claims/patient

Avg Cost/Claim

$76

Monthly Spending Trend

Yearly Spending

2018
$1.5M
+63%
2019
$2.4M
+13%
2020
$2.7M
-67%
2021
$889K
+29%
2022
$1.1M
-91%
2023
$101K
-26%
2024
$75K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 27 distinct procedure codes. The top code (H0038 (Self-help/peer services, per 15 minutes)) accounts for 23% of total spending.

H0038Top 25%

Self-help/peer services, per 15 minutes

$2.0M

17K claims · 22.8%

Your Cost: $118.81/claim|Median: $55.04
2.2× median
H2017Normal range

Psychosocial rehabilitation services, per 15 min

$1.7M

16K claims · 19.3%

Your Cost: $106.82/claim|Median: $91.63
1.2× median
90834Normal range

Psychotherapy, 45 minutes

$1.6M

31K claims · 18.0%

Your Cost: $50.09/claim|Median: $63.65
0.8× median
T1017Normal range

Targeted case management, per 15 min

$1.6M

21K claims · 17.8%

Your Cost: $75.47/claim|Median: $69.56
1.1× median
H0035Top 10%

Mental health partial hospitalization, treatment, per hour

$380K

887 claims · 4.4%

Your Cost: $428.50/claim|Median: $148.53
2.9× median
H0046Normal range

Mental health services, not otherwise specified

$268K

2,784 claims · 3.1%

Your Cost: $96.32/claim|Median: $85.02
1.1× median
90847Normal range

Family psychotherapy with patient, 50 min

$266K

3,528 claims · 3.1%

Your Cost: $75.32/claim|Median: $77.33
1.0× median
T1016Normal range

Case management, each 15 min

$253K

3,936 claims · 2.9%

Your Cost: $64.27/claim|Median: $49.62
1.3× median
H0032Normal range

Mental health service plan development

$162K

2,406 claims · 1.9%

Your Cost: $67.38/claim|Median: $80.64
0.8× median
90846Normal range

Family psychotherapy without patient, 50 min

$106K

1,475 claims · 1.2%

Your Cost: $72.06/claim|Median: $76.61
0.9× median
H2012Normal range

Behavioral health day treatment, per hour

$94K

718 claims · 1.1%

Your Cost: $131.07/claim|Median: $137.86
1.0× median
90791Normal range

Psychiatric diagnostic evaluation

$90K

1,044 claims · 1.0%

Your Cost: $86.53/claim|Median: $99.21
0.9× median
S5150Normal range

Unskilled respite care, per 15 min

$53K

630 claims · 0.6%

Your Cost: $83.55/claim|Median: $84.46
1.0× median
T2002Normal range

Non-emergency transport; per trip

$51K

2,915 claims · 0.6%

Your Cost: $17.57/claim|Median: $19.35
0.9× median
H1011Normal range

$40K

537 claims · 0.5%

Your Cost: $74.00/claim|Median: $47.19
1.6× median
90837Normal range

Psychotherapy, 60 minutes

$33K

466 claims · 0.4%

Your Cost: $71.06/claim|Median: $85.66
0.8× median
H0031Normal range

Mental health assessment by non-physician

$33K

417 claims · 0.4%

Your Cost: $78.65/claim|Median: $96.18
0.8× median
T1014Normal range

$32K

1,680 claims · 0.4%

Your Cost: $19.08/claim|Median: $12.88
1.5× median
H2014Normal range

Skills training & development, per 15 min

$25K

536 claims · 0.3%

Your Cost: $46.57/claim|Median: $83.88
0.6× median
90785Normal range

$17K

4,577 claims · 0.2%

Your Cost: $3.81/claim|Median: $6.43
0.6× median
99214Normal range

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

$6K

677 claims · 0.1%

Your Cost: $9.48/claim|Median: $53.41
0.2× median
H0023Normal range

Behavioral health outreach service, per 15 minutes

$3K

109 claims · 0.0%

Your Cost: $29.11/claim|Median: $53.97
0.5× median
99213Normal range

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

$2K

304 claims · 0.0%

Your Cost: $5.31/claim|Median: $37.81
0.1× median
90832Normal range

Psychotherapy, 30 minutes

$2K

42 claims · 0.0%

Your Cost: $37.81/claim|Median: $41.28
0.9× median
90833Normal range

Psychotherapy, 30 min, add-on to E/M service

$509

92 claims · 0.0%

Your Cost: $5.53/claim|Median: $38.83
0.1× median
80305Normal range

$38

55 claims · 0.0%

Your Cost: $0.69/claim|Median: $7.44
0.1× median
U0002Normal range

COVID-19 lab test, non-CDC, nucleic acid

$4

18 claims · 0.0%

Your Cost: $0.24/claim|Median: $34.62
0.0× median
← All providersHow we detect fraud →