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Tommel Hayes

Social Worker, Clinical·Goldsboro, NC·NPI: 1467789776SharePrint ReportML Risk: 86%

Compared to Social Worker, Clinical Peers

Total spending distribution among 34 providers in this specialty

P25MedianP75P90

This provider's total spending of $360K is at the 50th percentile among 34 Social Worker, Clinical providers.

Total Paid

$360K

$360,072

Total Claims

4,057

Beneficiaries

800

5.1 claims/patient

Avg Cost/Claim

$89

🔍 Analysis

Provider Overview

Tommel Hayes is a Social Worker, Clinical provider based in Goldsboro, NC. From 2018-01 through 2019-01, this provider received $360K in Medicaid payments across 4K claims serving 800 beneficiaries, billing 4 distinct procedure codes.

Key Findings

  • 📊Billing stopped in 2019-01, suggesting this provider is no longer active in Medicaid. Abrupt cessation of billing can be a risk indicator.

Yearly Spending

2018
$334K
-92%
2019
$26K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 4 distinct procedure codes. The top code (90837 (Psychotherapy, 60 minutes)) accounts for 68% of total spending.

90837Top 25%

Psychotherapy, 60 minutes

$244K

2,221 claims · 67.7%

Your Cost: $109.78/claim|Median: $85.66
1.3× median
90846Normal range

Family psychotherapy without patient, 50 min

$98K

970 claims · 27.1%

Your Cost: $100.75/claim|Median: $76.61
1.3× median
90853Normal range

Group psychotherapy

$14K

833 claims · 3.8%

Your Cost: $16.33/claim|Median: $25.02
0.7× median
90791Top 25%

Psychiatric diagnostic evaluation

$5K

33 claims · 1.4%

Your Cost: $149.28/claim|Median: $99.21
1.5× median