Is Provider 1558512327 flagged for Medicaid fraud?

Provider 1558512327 (NPI: 1558512327) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does Provider 1558512327 bill Medicaid?

Provider 1558512327 received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records.

What is NPI 1558512327?

NPI 1558512327 is the National Provider Identifier for Provider 1558512327.. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

Provider 1558512327

NPI: 1558512327Share

Active Billing Period:2018-01→2024-11(82 months)

Total Paid

$8.8M

$8,834,237

Total Claims

228K

Beneficiaries

65K

3.5 claims/patient

Avg Cost/Claim

$39

Monthly Spending Trend

Yearly Spending

2018

$945K

+27%

2019

$1.2M

-19%

2020

$970K

+12%

2021

$1.1M

+34%

2022

$1.5M

+8%

2023

$1.6M

+2%

2024

$1.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 11 distinct procedure codes. The top code (97110 (Therapeutic exercises, each 15 min)) accounts for 44% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

97110Therapeutic exercises, each 15 minSee all providers →

$3.9M

80K claims

$47.97

$24.49

2.0×

Top 25%

97110Top 25%

Therapeutic exercises, each 15 min

$3.9M

80K claims · 43.7%

Your Cost: $47.97/claim|Median: $24.49

2.0× median

97140Manual therapy techniques, per 15 minutesSee all providers →

$1.7M

63K claims

$26.40

$16.79

1.6×

Top 25%

97140Top 25%

Manual therapy techniques, per 15 minutes

$1.7M

63K claims · 18.7%

Your Cost: $26.40/claim|Median: $16.79

1.6× median

97113 See all providers →

$1.4M

14K claims

$103.74

$51.02

2.0×

Top 10%

97113Top 10%

$1.4M

14K claims · 16.2%

Your Cost: $103.74/claim|Median: $51.02

2.0× median

97112Therapeutic procedure, neuromuscular reeducation, per 15 minutesSee all providers →

$1.4M

55K claims

$25.31

$20.04

1.3×

Normal range

97112Normal range

Therapeutic procedure, neuromuscular reeducation, per 15 minutes

$1.4M

55K claims · 15.8%

Your Cost: $25.31/claim|Median: $20.04

1.3× median

99243Office or other outpatient consultation, low complexitySee all providers →

$474K

6,219 claims

$76.24

$82.43

0.9×

Normal range

99243Normal range

Office or other outpatient consultation, low complexity

$474K

6,219 claims · 5.4%

Your Cost: $76.24/claim|Median: $82.43

0.9× median

97032Electrical stimulation, manualSee all providers →

$21K

9,771 claims

$2.19

$9.42

0.2×

Normal range

97032Normal range

Electrical stimulation, manual

$21K

9,771 claims · 0.2%

Your Cost: $2.19/claim|Median: $9.42

0.2× median

97161Physical therapy evaluation, low complexitySee all providers →

$1K

100 claims

$13.87

$47.89

0.3×

Normal range

97161Normal range

Physical therapy evaluation, low complexity

$1K

100 claims · 0.0%

Your Cost: $13.87/claim|Median: $47.89

0.3× median

97014Electrical stimulation, unattendedSee all providers →

$464

260 claims

$1.79

$8.83

0.2×

Normal range

97014Normal range

Electrical stimulation, unattended

$464

260 claims · 0.0%

Your Cost: $1.79/claim|Median: $8.83

0.2× median

99242Office consultation, low complexitySee all providers →

$357

29 claims

$12.32

$57.97

0.2×

Normal range

99242Normal range

Office consultation, low complexity

$357

29 claims · 0.0%

Your Cost: $12.32/claim|Median: $57.97

0.2× median

97016 See all providers →

$75

28 claims

$2.69

$8.30

0.3×

Normal range

97016Normal range

$75

28 claims · 0.0%

Your Cost: $2.69/claim|Median: $8.30

0.3× median

97164PT re-evaluationSee all providers →

29 claims

$0.00

$32.66

—

Normal range

97164Normal range

PT re-evaluation

29 claims · 0.0%

Your Cost: $0.00/claim|Median: $32.66

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