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Mildred Martinez

Nurse Practitioner, Gerontology·Henderson, NV·NPI: 1578635140SharePrint ReportML Risk: 85%

Total Paid

$143K

$143,435

Total Claims

2,845

Beneficiaries

773

3.7 claims/patient

Avg Cost/Claim

$50

🔍 Analysis

Provider Overview

Mildred Martinez is a Nurse Practitioner, Gerontology provider based in Henderson, NV. From 2018-02 through 2018-11, this provider received $143K in Medicaid payments across 3K claims serving 773 beneficiaries, billing 5 distinct procedure codes.

Key Findings

  • 📊Bills 3.4× the national median for 99309 (99309), at $48 per claim vs. the median of $14. This places them well above the 99th percentile nationally.
  • 📊78% of billing is concentrated in 99309 (99309), indicating significant specialization in this service.
  • 📊Billing stopped in 2018-11, suggesting this provider is no longer active in Medicaid. Abrupt cessation of billing can be a risk indicator.

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 5 distinct procedure codes. The top code (99309 (Nursing facility care, subsequent, low complexity)) accounts for 78% of total spending.

99309Top 10%

Nursing facility care, subsequent, low complexity

$112K

2,354 claims · 78.1%

Your Cost: $47.61/claim|Median: $14.00
3.4× median
99310Top 10%

$14K

193 claims · 9.9%

Your Cost: $73.39/claim|Median: $21.82
3.4× median
99316Top 25%

$8K

153 claims · 5.9%

Your Cost: $55.26/claim|Median: $25.78
2.1× median
99223Top 25%

Initial hospital care, per day, high complexity

$5K

48 claims · 3.4%

Your Cost: $100.41/claim|Median: $67.32
1.5× median
99233Normal range

Subsequent hospital care, per day, high complexity

$4K

97 claims · 2.7%

Your Cost: $40.53/claim|Median: $35.30
1.1× median