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

⚖️ Compare🖨️ Print Report

Provider 1295056919

NPI: 1295056919Share
Active Billing Period:2019-01→2023-08(56 months)
Billing appears to have stoppedLast active: 2023-08

Total Paid

$13.0M

$13,007,856

Total Claims

131K

Beneficiaries

29K

4.5 claims/patient

Avg Cost/Claim

$99

Monthly Spending Trend

Yearly Spending

2019
$227K
+144%
2020
$556K
+76%
2021
$975K
-20%
2022
$780K
+1243%
2023
$10.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (H2014 (Skills training & development, per 15 min)) accounts for 25% of total spending.

H2014Top 25%

Skills training & development, per 15 min

$3.3M

15K claims · 25.5%

Your Cost: $215.06/claim|Median: $83.88
2.6× median
36478Normal range

$1.5M

2,393 claims · 11.8%

Your Cost: $640.41/claim|Median: $864.49
0.7× median
H0038Top 25%

Self-help/peer services, per 15 minutes

$1.1M

8,934 claims · 8.1%

Your Cost: $118.61/claim|Median: $55.04
2.2× median
H0015Normal range

Alcohol and/or drug abuse, intensive outpatient, per hour

$1.1M

12K claims · 8.1%

Your Cost: $84.91/claim|Median: $129.75
0.7× median
T1016Top 25%

Case management, each 15 min

$1.0M

8,872 claims · 7.8%

Your Cost: $114.49/claim|Median: $49.62
2.3× median
H2020Normal range

Day habilitation, waiver, per 15 minutes

$987K

13K claims · 7.6%

Your Cost: $77.77/claim|Median: $144.05
0.5× median
H0031Normal range

Mental health assessment by non-physician

$970K

9,477 claims · 7.5%

Your Cost: $102.30/claim|Median: $96.18
1.1× median
H0004Normal range

Behavioral health counseling & therapy, per 15 min

$748K

12K claims · 5.7%

Your Cost: $61.59/claim|Median: $74.63
0.8× median
H2027Normal range

Psychoeducational service, per 15 minutes

$487K

12K claims · 3.7%

Your Cost: $40.16/claim|Median: $82.72
0.5× median
36465Normal range

$480K

567 claims · 3.7%

Your Cost: $846.23/claim|Median: $792.14
1.1× median
93970Normal range

Duplex scan of extremity veins, complete, bilateral

$302K

3,601 claims · 2.3%

Your Cost: $83.89/claim|Median: $43.07
1.9× median
93971Normal range

Duplex scan of extremity veins, unilateral or limited

$216K

3,499 claims · 1.7%

Your Cost: $61.80/claim|Median: $25.43
2.4× median
36471Normal range

$189K

1,355 claims · 1.5%

Your Cost: $139.21/claim|Median: $105.39
1.3× median
H0025Normal range

Behavioral health prevention education, per session

$90K

13K claims · 0.7%

Your Cost: $7.13/claim|Median: $36.25
0.2× median
90792Top 25%

Psychiatric diagnostic evaluation with medical services

$86K

453 claims · 0.7%

Your Cost: $189.05/claim|Median: $108.91
1.7× median
93925Normal range

$84K

787 claims · 0.6%

Your Cost: $106.25/claim|Median: $54.12
2.0× median
36482Top 25%

$82K

58 claims · 0.6%

Your Cost: $1,421.59/claim|Median: $560.60
2.5× median
99213Normal range

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

$76K

2,700 claims · 0.6%

Your Cost: $28.25/claim|Median: $37.81
0.7× median
99214Normal range

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

$70K

1,392 claims · 0.5%

Your Cost: $50.54/claim|Median: $53.41
0.9× median
99204Normal range

Office/outpatient visit, new patient, mod-high complexity

$39K

675 claims · 0.3%

Your Cost: $58.33/claim|Median: $84.03
0.7× median
99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$39K

1,111 claims · 0.3%

Your Cost: $35.04/claim|Median: $57.85
0.6× median
97140Top 25%

Manual therapy techniques, per 15 minutes

$21K

709 claims · 0.2%

Your Cost: $29.72/claim|Median: $16.79
1.8× median
97110Normal range

Therapeutic exercises, each 15 min

$13K

449 claims · 0.1%

Your Cost: $28.43/claim|Median: $24.49
1.2× median
93922Normal range

$8K

206 claims · 0.1%

Your Cost: $37.79/claim|Median: $26.06
1.5× median
97112Normal range

Therapeutic procedure, neuromuscular reeducation, per 15 minutes

$6K

206 claims · 0.0%

Your Cost: $29.91/claim|Median: $20.04
1.5× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$6K

156 claims · 0.0%

Your Cost: $38.99/claim|Median: $111.09
0.4× median
97530Normal range

Therapeutic activities, each 15 min

$5K

161 claims · 0.0%

Your Cost: $31.08/claim|Median: $33.11
0.9× median
97161Top 25%

Physical therapy evaluation, low complexity

$5K

52 claims · 0.0%

Your Cost: $93.62/claim|Median: $47.89
2.0× median
H0001Normal range

Alcohol and/or drug assessment

$5K

419 claims · 0.0%

Your Cost: $10.98/claim|Median: $94.22
0.1× median
73630Normal range

X-ray, foot, complete, minimum 3 views

$3K

292 claims · 0.0%

Your Cost: $11.69/claim|Median: $12.06
1.0× median
← All providersHow we detect fraud →