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

⚖️ Compare🖨️ Print Report

Provider 1396001798

NPI: 1396001798Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$12.8M

$12,802,792

Total Claims

291K

Beneficiaries

56K

5.2 claims/patient

Avg Cost/Claim

$44

Monthly Spending Trend

Yearly Spending

2018
$2.3M
+5%
2019
$2.4M
-44%
2020
$1.3M
+46%
2021
$1.9M
-7%
2022
$1.8M
-7%
2023
$1.7M
-19%
2024
$1.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 16 distinct procedure codes. The top code (H0020 (Alcohol/drug services; methadone administration)) accounts for 60% of total spending.

H0020Top 25%

Alcohol/drug services; methadone administration

$7.7M

103K claims · 60.0%

Your Cost: $74.35/claim|Median: $18.95
3.9× median
J0574Normal range

$1.6M

96K claims · 12.4%

Your Cost: $16.62/claim|Median: $15.76
1.1× median
H0004Normal range

Behavioral health counseling & therapy, per 15 min

$1.6M

21K claims · 12.2%

Your Cost: $74.38/claim|Median: $74.63
1.0× median
H0047Normal range

Alcohol and/or drug abuse, not otherwise specified

$991K

15K claims · 7.7%

Your Cost: $64.70/claim|Median: $81.37
0.8× median
J0572Normal range

$475K

52K claims · 3.7%

Your Cost: $9.13/claim|Median: $8.49
1.1× median
H0001Top 25%

Alcohol and/or drug assessment

$282K

1,628 claims · 2.2%

Your Cost: $172.96/claim|Median: $94.22
1.8× median
H0016Top 25%

Alcohol or drug abuse services, prenatal

$150K

650 claims · 1.2%

Your Cost: $231.23/claim|Median: $182.66
1.3× median
99213Top 5%

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

$17K

182 claims · 0.1%

Your Cost: $95.87/claim|Median: $37.81
2.5× median
G2067Normal range

Medication-assisted treatment, opioid use disorder, per month

$17K

256 claims · 0.1%

Your Cost: $67.74/claim|Median: $73.29
0.9× median
99214Top 5%

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

$9K

74 claims · 0.1%

Your Cost: $126.06/claim|Median: $53.41
2.4× median
H0005Normal range

Alcohol and/or drug services, group counseling

$9K

205 claims · 0.1%

Your Cost: $45.30/claim|Median: $47.35
1.0× median
W9520Normal range

$6K

625 claims · 0.0%

Your Cost: $9.48/claim|Median: $10.26
0.9× median
J0573Normal range

$3K

177 claims · 0.0%

Your Cost: $14.38/claim|Median: $12.82
1.1× median
G2078Top 5%

$2K

13 claims · 0.0%

Your Cost: $189.01/claim|Median: $27.04
7.0× median
99211Top 25%

Office/outpatient visit, minimal complexity

$2K

95 claims · 0.0%

Your Cost: $23.84/claim|Median: $12.93
1.8× median
99212Top 10%

Office/outpatient visit, low complexity

$2K

28 claims · 0.0%

Your Cost: $57.42/claim|Median: $25.06
2.3× median
← All providersHow we detect fraud →