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

⚖️ Compare🖨️ Print Report

Provider 1497148407

NPI: 1497148407Share
Active Billing Period:2018-01→2024-12(79 months)

Total Paid

$7.5M

$7,521,495

Total Claims

72K

Beneficiaries

58K

1.2 claims/patient

Avg Cost/Claim

$105

Monthly Spending Trend

Yearly Spending

2018
$261K
-36%
2019
$166K
+214%
2020
$521K
-5%
2021
$496K
+267%
2022
$1.8M
+48%
2023
$2.7M
-41%
2024
$1.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (T1040 (Medicaid certified CCBHC services)) accounts for 35% of total spending.

T1040Normal range

Medicaid certified CCBHC services

$2.7M

19K claims · 35.4%

Your Cost: $138.51/claim|Median: $130.29
1.1× median
G0470Top 10%

Chronic care management services, FQHC/RHC

$2.6M

14K claims · 34.5%

Your Cost: $191.72/claim|Median: $45.95
4.2× median
T1015Top 25%

Clinic visit/encounter, all-inclusive

$716K

3,365 claims · 9.5%

Your Cost: $212.68/claim|Median: $121.16
1.8× median
D9450Top 10%

$211K

3,576 claims · 2.8%

Your Cost: $58.94/claim|Median: $21.95
2.7× median
99391Top 1%

Preventive medicine, established patient, infant (under 1)

$185K

853 claims · 2.5%

Your Cost: $216.79/claim|Median: $69.35
3.1× median
90834Top 25%

Psychotherapy, 45 minutes

$177K

2,064 claims · 2.4%

Your Cost: $85.73/claim|Median: $63.65
1.3× median
99392Top 1%

Preventive medicine, established patient, age 1-4

$147K

677 claims · 1.9%

Your Cost: $216.43/claim|Median: $75.18
2.9× median
G0469Top 25%

$109K

572 claims · 1.5%

Your Cost: $190.94/claim|Median: $70.42
2.7× median
99393Top 1%

Preventive medicine, established patient, age 5-11

$94K

450 claims · 1.2%

Your Cost: $208.19/claim|Median: $74.82
2.8× median
99213Normal range

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

$92K

1,763 claims · 1.2%

Your Cost: $51.97/claim|Median: $37.81
1.4× median
90460Top 25%

Immunization administration, first vaccine/toxoid, with counseling

$87K

2,396 claims · 1.2%

Your Cost: $36.22/claim|Median: $17.85
2.0× median
99394Top 5%

Preventive medicine, established patient, age 12-17

$81K

391 claims · 1.1%

Your Cost: $207.24/claim|Median: $80.15
2.6× median
90832Normal range

Psychotherapy, 30 minutes

$56K

1,307 claims · 0.7%

Your Cost: $42.79/claim|Median: $41.28
1.0× median
D1206Normal range

Topical application of fluoride varnish

$52K

2,911 claims · 0.7%

Your Cost: $18.01/claim|Median: $18.12
1.0× median
D0145Normal range

Oral evaluation for patient under 3 years, counseling

$52K

3,111 claims · 0.7%

Your Cost: $16.60/claim|Median: $57.30
0.3× median
90791Normal range

Psychiatric diagnostic evaluation

$27K

232 claims · 0.4%

Your Cost: $117.70/claim|Median: $99.21
1.2× median
96110Normal range

Developmental screening, per standardized instrument

$21K

2,247 claims · 0.3%

Your Cost: $9.19/claim|Median: $9.10
1.0× median
99214Normal range

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

$19K

352 claims · 0.3%

Your Cost: $55.25/claim|Median: $53.41
1.0× median
99384Top 5%

Preventive visit, new patient, adolescent (12-17 yr)

$16K

83 claims · 0.2%

Your Cost: $192.58/claim|Median: $83.63
2.3× median
99173Top 5%

$15K

688 claims · 0.2%

Your Cost: $21.36/claim|Median: $2.16
9.9× median
99383Top 5%

Preventive visit, new patient, late childhood (5-11 yr)

$13K

61 claims · 0.2%

Your Cost: $207.44/claim|Median: $81.92
2.5× median
87502Normal range

Influenza virus detection, reverse transcription, amplified probe

$11K

318 claims · 0.1%

Your Cost: $35.00/claim|Median: $65.64
0.5× median
99050Top 5%

$9K

186 claims · 0.1%

Your Cost: $47.31/claim|Median: $11.81
4.0× median
87426Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$8K

232 claims · 0.1%

Your Cost: $35.33/claim|Median: $30.04
1.2× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$8K

77 claims · 0.1%

Your Cost: $103.69/claim|Median: $108.91
1.0× median
99395Top 5%

Preventive medicine, established patient, age 18-39

$8K

42 claims · 0.1%

Your Cost: $179.71/claim|Median: $72.71
2.5× median
99381Top 1%

Preventive visit, new patient, infant (<1 yr)

$6K

29 claims · 0.1%

Your Cost: $222.00/claim|Median: $73.46
3.0× median
96127Top 25%

Brief emotional/behavioral assessment, per standardized instrument

$6K

1,004 claims · 0.1%

Your Cost: $6.36/claim|Median: $3.67
1.7× median
87880Top 25%

Streptococcus, Group A, rapid antigen detection

$5K

327 claims · 0.1%

Your Cost: $14.04/claim|Median: $11.48
1.2× median
0124ATop 25%

$4K

97 claims · 0.1%

Your Cost: $40.20/claim|Median: $34.32
1.2× median
← All providersHow we detect fraud →