Is BOWER ENTERPRISES INC flagged for Medicaid fraud?

BOWER ENTERPRISES INC (NPI: 1336391911) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does BOWER ENTERPRISES INC bill Medicaid?

BOWER ENTERPRISES INC received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Community/Behavioral Health provider. Located in TROY, MI.

What is NPI 1336391911?

NPI 1336391911 is the National Provider Identifier for BOWER ENTERPRISES INC. They are a Community/Behavioral Health provider based in TROY, MI. This NPI is registered with the CMS NPI Registry.

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BOWER ENTERPRISES INC

Community/Behavioral Health·TROY, MI·NPI: 1336391911Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $59.2M is at the 50th percentile among 218 Community/Behavioral Health providers.

Active Billing Period:2018-01→2024-07(79 months)

Total Paid

$59.2M

$59,233,634

Total Claims

552K

Beneficiaries

74K

7.5 claims/patient

Avg Cost/Claim

$107

Monthly Spending Trend

Yearly Spending

2018

$2.9M

+198%

2019

$8.5M

+9%

2020

$9.3M

+10%

2021

$10.2M

+12%

2022

$11.5M

+10%

2023

$12.7M

-68%

2024

$4.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 14 distinct procedure codes. The top code (H2015 (Comprehensive community support services, per 15 min)) accounts for 65% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H2015Comprehensive community support services, per 15 minSee all providers →

$38.7M

320K claims

$121.04

$96.24

1.3×

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

$38.7M

320K claims · 65.4%

Your Cost: $121.04/claim|Median: $96.24

1.3× median

T1005Respite care services, per 15 minutesSee all providers →

$7.8M

107K claims

$73.10

$71.40

1.0×

Normal range

T1005Normal range

Respite care services, per 15 minutes

$7.8M

107K claims · 13.2%

Your Cost: $73.10/claim|Median: $71.40

1.0× median

S5111Home care training, family member, per sessionSee all providers →

$4.1M

44K claims

$94.21

$87.13

1.1×

Normal range

S5111Normal range

Home care training, family member, per session

$4.1M

44K claims · 6.9%

Your Cost: $94.21/claim|Median: $87.13

1.1× median

97530Therapeutic activities, each 15 minSee all providers →

$3.4M

33K claims

$103.26

$33.11

3.1×

Top 5%

97530Top 5%

Therapeutic activities, each 15 min

$3.4M

33K claims · 5.7%

Your Cost: $103.26/claim|Median: $33.11

3.1× median

92507Speech/hearing/language treatmentSee all providers →

$2.4M

22K claims

$108.56

$49.45

2.2×

Top 5%

92507Top 5%

Speech/hearing/language treatment

$2.4M

22K claims · 4.0%

Your Cost: $108.56/claim|Median: $49.45

2.2× median

H0043Supported housing, per diemSee all providers →

$1.3M

10K claims

$131.88

$164.87

0.8×

Normal range

H0043Normal range

Supported housing, per diem

$1.3M

10K claims · 2.3%

Your Cost: $131.88/claim|Median: $164.87

0.8× median

H0032Mental health service plan developmentSee all providers →

$814K

6,632 claims

$122.81

$80.64

1.5×

Normal range

H0032Normal range

Mental health service plan development

$814K

6,632 claims · 1.4%

Your Cost: $122.81/claim|Median: $80.64

1.5× median

97110Therapeutic exercises, each 15 minSee all providers →

$256K

3,751 claims

$68.36

$24.49

2.8×

Top 10%

97110Top 10%

Therapeutic exercises, each 15 min

$256K

3,751 claims · 0.4%

Your Cost: $68.36/claim|Median: $24.49

2.8× median

97533 See all providers →

$241K

4,757 claims

$50.62

$48.71

1.0×

Normal range

97533Normal range

$241K

4,757 claims · 0.4%

Your Cost: $50.62/claim|Median: $48.71

1.0× median

92523Evaluation of speech sound production with language comprehensionSee all providers →

$100K

661 claims

$151.20

$110.87

1.4×

Top 25%

92523Top 25%

Evaluation of speech sound production with language comprehension

$100K

661 claims · 0.2%

Your Cost: $151.20/claim|Median: $110.87

1.4× median

97168OT re-evaluationSee all providers →

$81K

891 claims

$91.29

$50.43

1.8×

Top 25%

97168Top 25%

OT re-evaluation

$81K

891 claims · 0.1%

Your Cost: $91.29/claim|Median: $50.43

1.8× median

S9445 See all providers →

$11K

148 claims

$75.00

$12.72

5.9×

Top 10%

S9445Top 10%

$11K

148 claims · 0.0%

Your Cost: $75.00/claim|Median: $12.72

5.9× median

97165OT evaluation, low complexitySee all providers →

$8K

177 claims

$46.54

$46.78

1.0×

Normal range

97165Normal range

OT evaluation, low complexity

$8K

177 claims · 0.0%

Your Cost: $46.54/claim|Median: $46.78

1.0× median

97166OT evaluation, moderate complexitySee all providers →

$5K

31 claims

$150.00

$48.74

3.1×

Top 5%

97166Top 5%

OT evaluation, moderate complexity

$5K

31 claims · 0.0%

Your Cost: $150.00/claim|Median: $48.74

3.1× median

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