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

⚖️ Compare🖨️ Print Report

Provider 1295911386

NPI: 1295911386Share
Active Billing Period:2021-02→2024-12(47 months)

Total Paid

$15.0M

$14,981,713

Total Claims

109K

Beneficiaries

9,508

11.4 claims/patient

Avg Cost/Claim

$138

Monthly Spending Trend

Yearly Spending

2021
$2.3M
+72%
2022
$4.0M
+8%
2023
$4.4M
-3%
2024
$4.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 19 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 53% of total spending.

H2016Normal range

Comprehensive community support services, per 15 min

$8.0M

15K claims · 53.3%

Your Cost: $534.64/claim|Median: $321.53
1.7× median
T2016Normal range

Habilitation, residential, waiver; per diem

$1.9M

17K claims · 12.4%

Your Cost: $109.35/claim|Median: $331.94
0.3× median
M0123Top 1%

$1.2M

16K claims · 7.9%

Your Cost: $76.14/claim|Median: $76.14
1.0× median
M0125Top 1%

$1.1M

11K claims · 7.1%

Your Cost: $94.07/claim|Median: $94.07
1.0× median
H2014Normal range

Skills training & development, per 15 min

$875K

21K claims · 5.8%

Your Cost: $42.31/claim|Median: $83.88
0.5× median
T2020Normal range

Day habilitation, waiver; per diem

$403K

3,116 claims · 2.7%

Your Cost: $129.46/claim|Median: $87.34
1.5× median
M0122Top 1%

$379K

5,225 claims · 2.5%

Your Cost: $72.56/claim|Median: $72.56
1.0× median
S5150Normal range

Unskilled respite care, per 15 min

$284K

2,870 claims · 1.9%

Your Cost: $98.96/claim|Median: $84.46
1.2× median
M0116Normal range

$265K

8,310 claims · 1.8%

Your Cost: $31.85/claim|Median: $32.07
1.0× median
M0118Normal range

$206K

5,478 claims · 1.4%

Your Cost: $37.67/claim|Median: $38.00
1.0× median
M0360Normal range

$161K

1,561 claims · 1.1%

Your Cost: $102.98/claim|Median: $102.43
1.0× median
D0120Top 1%

Periodic oral evaluation, established patient

$98K

271 claims · 0.7%

Your Cost: $360.94/claim|Median: $24.34
14.8× median
T1002Top 25%

RN services, per 15 minutes

$83K

1,105 claims · 0.6%

Your Cost: $75.23/claim|Median: $37.42
2.0× median
M0113Normal range

$34K

86 claims · 0.2%

Your Cost: $392.79/claim|Median: $397.30
1.0× median
M0240Normal range

$30K

309 claims · 0.2%

Your Cost: $96.42/claim|Median: $141.71
0.7× median
H2019Normal range

Therapeutic behavioral services, per 15 min

$26K

295 claims · 0.2%

Your Cost: $89.37/claim|Median: $84.12
1.1× median
M0299Top 25%

$23K

350 claims · 0.2%

Your Cost: $65.94/claim|Median: $34.98
1.9× median
M0133Normal range

$11K

111 claims · 0.1%

Your Cost: $100.13/claim|Median: $84.70
1.2× median
M0315Normal range

$2K

72 claims · 0.0%

Your Cost: $30.45/claim|Median: $29.80
1.0× median
← All providersHow we detect fraud →