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

⚖️ Compare🖨️ Print Report

Provider 1558400333

NPI: 1558400333Share
Active Billing Period:2020-12→2024-12(49 months)

Total Paid

$11.7M

$11,657,136

Total Claims

86K

Beneficiaries

8,752

9.8 claims/patient

Avg Cost/Claim

$136

Monthly Spending Trend

Yearly Spending

2020
$3K
+68179%
2021
$2.4M
+44%
2022
$3.4M
-8%
2023
$3.1M
-13%
2024
$2.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 15 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 61% of total spending.

H2016Normal range

Comprehensive community support services, per 15 min

$7.2M

14K claims · 61.4%

Your Cost: $499.01/claim|Median: $321.53
1.6× median
M0123Top 1%

$1.6M

21K claims · 13.9%

Your Cost: $76.14/claim|Median: $76.14
1.0× median
M0122Top 1%

$925K

13K claims · 7.9%

Your Cost: $72.56/claim|Median: $72.56
1.0× median
H2014Normal range

Skills training & development, per 15 min

$521K

14K claims · 4.5%

Your Cost: $36.04/claim|Median: $83.88
0.4× median
M0125Top 1%

$479K

5,088 claims · 4.1%

Your Cost: $94.07/claim|Median: $94.07
1.0× median
T2020Normal range

Day habilitation, waiver; per diem

$323K

2,897 claims · 2.8%

Your Cost: $111.59/claim|Median: $87.34
1.3× median
M0116Normal range

$259K

8,142 claims · 2.2%

Your Cost: $31.80/claim|Median: $32.07
1.0× median
M0115Normal range

$102K

3,570 claims · 0.9%

Your Cost: $28.53/claim|Median: $29.58
1.0× median
D0120Top 1%

Periodic oral evaluation, established patient

$101K

297 claims · 0.9%

Your Cost: $340.95/claim|Median: $24.34
14.0× median
M0113Normal range

$73K

185 claims · 0.6%

Your Cost: $392.89/claim|Median: $397.30
1.0× median
T1002Normal range

RN services, per 15 minutes

$45K

1,237 claims · 0.4%

Your Cost: $36.35/claim|Median: $37.42
1.0× median
M0299Top 5%

$30K

266 claims · 0.3%

Your Cost: $111.86/claim|Median: $34.98
3.2× median
M0315Normal range

$11K

384 claims · 0.1%

Your Cost: $27.57/claim|Median: $29.80
0.9× median
M0298Normal range

$5K

481 claims · 0.0%

Your Cost: $10.79/claim|Median: $13.85
0.8× median
T1003Normal range

LPN/LVN services, per 15 minutes

$5K

342 claims · 0.0%

Your Cost: $13.38/claim|Median: $24.24
0.6× median
← All providersHow we detect fraud →