Is Provider 1306131545 flagged for Medicaid fraud?

Provider 1306131545 (NPI: 1306131545) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does Provider 1306131545 bill Medicaid?

Provider 1306131545 received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records.

What is NPI 1306131545?

NPI 1306131545 is the National Provider Identifier for Provider 1306131545.. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

Provider 1306131545

NPI: 1306131545Share

Active Billing Period:2018-01→2022-08(56 months)

Billing appears to have stoppedLast active: 2022-08

Total Paid

$13.8M

$13,757,420

Total Claims

160K

Beneficiaries

132K

1.2 claims/patient

Avg Cost/Claim

$86

Monthly Spending Trend

Yearly Spending

2018

$3.9M

-8%

2019

$3.6M

-19%

2020

$2.9M

-21%

2021

$2.3M

-58%

2022

$983K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 84% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1015Clinic visit/encounter, all-inclusiveSee all providers →

$11.5M

71K claims

$161.24

$121.16

1.3×

Normal range

T1015Normal range

Clinic visit/encounter, all-inclusive

$11.5M

71K claims · 83.5%

Your Cost: $161.24/claim|Median: $121.16

1.3× median

00003Anesthesia servicesSee all providers →

$2.0M

10K claims

$191.76

$223.77

0.9×

Normal range

00003Normal range

Anesthesia services

$2.0M

10K claims · 14.4%

Your Cost: $191.76/claim|Median: $223.77

0.9× median

99213Office/outpatient visit, est. patient, low-mod complexitySee all providers →

$140K

20K claims

$7.13

$37.81

0.2×

Normal range

99213Normal range

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

$140K

20K claims · 1.0%

Your Cost: $7.13/claim|Median: $37.81

0.2× median

99212Office/outpatient visit, low complexitySee all providers →

$69K

4,709 claims

$14.61

$25.06

0.6×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$69K

4,709 claims · 0.5%

Your Cost: $14.61/claim|Median: $25.06

0.6× median

92004Ophthalmological exam, comprehensive, new patientSee all providers →

$31K

297 claims

$106.01

$59.72

1.8×

Top 25%

92004Top 25%

Ophthalmological exam, comprehensive, new patient

$31K

297 claims · 0.2%

Your Cost: $106.01/claim|Median: $59.72

1.8× median

J3490Unclassified drugsSee all providers →

$12K

189 claims

$65.41

$5.70

11.5×

Top 25%

J3490Top 25%

Unclassified drugs

$12K

189 claims · 0.1%

Your Cost: $65.41/claim|Median: $5.70

11.5× median

0012ACOVID-19 vaccine admin, Moderna, 2nd doseSee all providers →

$8K

240 claims

$31.56

$33.85

0.9×

Normal range

0012ANormal range

COVID-19 vaccine admin, Moderna, 2nd dose

$8K

240 claims · 0.1%

Your Cost: $31.56/claim|Median: $33.85

0.9× median

0011ACOVID-19 vaccine admin, Moderna, 1st doseSee all providers →

$7K

237 claims

$28.76

$25.93

1.1×

Normal range

0011ANormal range

COVID-19 vaccine admin, Moderna, 1st dose

$7K

237 claims · 0.0%

Your Cost: $28.76/claim|Median: $25.93

1.1× median

0001ACOVID-19 vaccine admin, Pfizer, 1st doseSee all providers →

$4K

125 claims

$35.68

$33.72

1.1×

Normal range

0001ANormal range

COVID-19 vaccine admin, Pfizer, 1st dose

$4K

125 claims · 0.0%

Your Cost: $35.68/claim|Median: $33.72

1.1× median

0002ACOVID-19 vaccine admin, Pfizer, 2nd doseSee all providers →

$3K

95 claims

$35.47

$36.70

1.0×

Normal range

0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$3K

95 claims · 0.0%

Your Cost: $35.47/claim|Median: $36.70

1.0× median

99203Office/outpatient visit, new patient, low-mod complexitySee all providers →

$3K

350 claims

$9.50

$57.85

0.2×

Normal range

99203Normal range

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

$3K

350 claims · 0.0%

Your Cost: $9.50/claim|Median: $57.85

0.2× median

99202Office/outpatient visit, new patient, low complexitySee all providers →

$2K

77 claims

$31.99

$40.11

0.8×

Normal range

99202Normal range

Office/outpatient visit, new patient, low complexity

$2K

77 claims · 0.0%

Your Cost: $31.99/claim|Median: $40.11

0.8× median

99000 See all providers →

$2K

6,547 claims

$0.35

$2.30

0.2×

Normal range

99000Normal range

$2K

6,547 claims · 0.0%

Your Cost: $0.35/claim|Median: $2.30

0.2× median

81025Urine pregnancy testSee all providers →

$2K

939 claims

$1.71

$4.81

0.4×

Normal range

81025Normal range

Urine pregnancy test

$2K

939 claims · 0.0%

Your Cost: $1.71/claim|Median: $4.81

0.4× median

0064A See all providers →

$1K

29 claims

$35.86

$34.17

1.0×

Normal range

0064ANormal range

$1K

29 claims · 0.0%

Your Cost: $35.86/claim|Median: $34.17

1.0× median

0071A See all providers →

$680

18 claims

$37.78

$38.71

1.0×

Normal range

0071ANormal range

$680

18 claims · 0.0%

Your Cost: $37.78/claim|Median: $38.71

1.0× median

0004A See all providers →

$480

13 claims

$36.92

$35.62

1.0×

Normal range

0004ANormal range

$480

13 claims · 0.0%

Your Cost: $36.92/claim|Median: $35.62

1.0× median

96110Developmental screening, per standardized instrumentSee all providers →

$359

275 claims

$1.31

$9.10

0.1×

Normal range

96110Normal range

Developmental screening, per standardized instrument

$359

275 claims · 0.0%

Your Cost: $1.31/claim|Median: $9.10

0.1× median

99214Office/outpatient visit, est. patient, mod-high complexitySee all providers →

$259

2,329 claims

$0.11

$53.41

0.0×

Normal range

99214Normal range

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

$259

2,329 claims · 0.0%

Your Cost: $0.11/claim|Median: $53.41

0.0× median

90832Psychotherapy, 30 minutesSee all providers →

$70

508 claims

$0.14

$41.28

0.0×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$70

508 claims · 0.0%

Your Cost: $0.14/claim|Median: $41.28

0.0× median

99391Preventive medicine, established patient, infant (under 1)See all providers →

$26

624 claims

$0.04

$69.35

0.0×

Normal range

99391Normal range

Preventive medicine, established patient, infant (under 1)

$26

624 claims · 0.0%

Your Cost: $0.04/claim|Median: $69.35

0.0× median

81003Urinalysis, automated without microscopySee all providers →

329 claims

$0.01

$1.48

0.0×

Normal range

81003Normal range

Urinalysis, automated without microscopy

329 claims · 0.0%

Your Cost: $0.01/claim|Median: $1.48

0.0× median

81000Urinalysis with microscopy, non-automatedSee all providers →

1,523 claims

$0.00

$2.51

0.0×

Normal range

81000Normal range

Urinalysis with microscopy, non-automated

1,523 claims · 0.0%

Your Cost: $0.00/claim|Median: $2.51

0.0× median

90471Immunization administration, 1 vaccine, percutaneous/ID/SC/IMSee all providers →

3,198 claims

$0.00

$9.80

0.0×

Normal range

90471Normal range

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

3,198 claims · 0.0%

Your Cost: $0.00/claim|Median: $9.80

0.0× median

85018 See all providers →

395 claims

$0.00

$1.71

—

Normal range

85018Normal range

395 claims · 0.0%

Your Cost: $0.00/claim|Median: $1.71

90686Influenza virus vaccine, quadrivalent, preservative-free, IMSee all providers →

1,209 claims

$0.00

$7.18

—

Normal range

90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

1,209 claims · 0.0%

Your Cost: $0.00/claim|Median: $7.18

90723DTaP-HepB-IPV vaccineSee all providers →

374 claims

$0.00

$5.78

—

Normal range

90723Normal range

DTaP-HepB-IPV vaccine

374 claims · 0.0%

Your Cost: $0.00/claim|Median: $5.78

3075F See all providers →

14 claims

$0.00

$0.15

—

Normal range

3075FNormal range

14 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.15

90744 See all providers →

30 claims

$0.00

$5.00

—

Normal range

90744Normal range

30 claims · 0.0%

Your Cost: $0.00/claim|Median: $5.00

90647 See all providers →

372 claims

$0.00

$4.31

—

Normal range

90647Normal range

372 claims · 0.0%

Your Cost: $0.00/claim|Median: $4.31

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