Is Provider 1578821005 flagged for Medicaid fraud?

Provider 1578821005 (NPI: 1578821005) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does Provider 1578821005 bill Medicaid?

Provider 1578821005 received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records.

What is NPI 1578821005?

NPI 1578821005 is the National Provider Identifier for Provider 1578821005.. This NPI is registered with the CMS NPI Registry.

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Provider 1578821005

NPI: 1578821005Share

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$15.0M

$15,040,616

Total Claims

274K

Beneficiaries

213K

1.3 claims/patient

Avg Cost/Claim

$55

Monthly Spending Trend

Yearly Spending

2018

$1.2M

+53%

2019

$1.9M

+17%

2020

$2.2M

+5%

2021

$2.3M

+9%

2022

$2.5M

-5%

2023

$2.4M

+0%

2024

$2.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 97% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1015Clinic visit/encounter, all-inclusiveSee all providers →

$14.6M

112K claims

$130.39

$121.16

1.1×

Normal range

T1015Normal range

Clinic visit/encounter, all-inclusive

$14.6M

112K claims · 96.8%

Your Cost: $130.39/claim|Median: $121.16

1.1× median

T1040Medicaid certified CCBHC servicesSee all providers →

$331K

4,243 claims

$77.98

$130.29

0.6×

Normal range

T1040Normal range

Medicaid certified CCBHC services

$331K

4,243 claims · 2.2%

Your Cost: $77.98/claim|Median: $130.29

0.6× median

D0999Unspecified diagnostic procedure, by reportSee all providers →

$107K

782 claims

$136.58

$101.33

1.3×

Normal range

D0999Normal range

Unspecified diagnostic procedure, by report

$107K

782 claims · 0.7%

Your Cost: $136.58/claim|Median: $101.33

1.3× median

99213Office/outpatient visit, est. patient, low-mod complexitySee all providers →

$5K

60K claims

$0.09

$37.81

0.0×

Normal range

99213Normal range

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

$5K

60K claims · 0.0%

Your Cost: $0.09/claim|Median: $37.81

0.0× median

0011ACOVID-19 vaccine admin, Moderna, 1st doseSee all providers →

$5K

120 claims

$40.59

$25.93

1.6×

Top 25%

0011ATop 25%

COVID-19 vaccine admin, Moderna, 1st dose

$5K

120 claims · 0.0%

Your Cost: $40.59/claim|Median: $25.93

1.6× median

0012ACOVID-19 vaccine admin, Moderna, 2nd doseSee all providers →

$4K

103 claims

$42.14

$33.85

1.2×

Top 25%

0012ATop 25%

COVID-19 vaccine admin, Moderna, 2nd dose

$4K

103 claims · 0.0%

Your Cost: $42.14/claim|Median: $33.85

1.2× median

90716 See all providers →

$3K

574 claims

$6.06

$6.18

1.0×

Normal range

90716Normal range

$3K

574 claims · 0.0%

Your Cost: $6.06/claim|Median: $6.18

1.0× median

90734 See all providers →

$2K

963 claims

$2.33

$6.40

0.4×

Normal range

90734Normal range

$2K

963 claims · 0.0%

Your Cost: $2.33/claim|Median: $6.40

0.4× median

90651HPV vaccine, 9-valentSee all providers →

$2K

2,057 claims

$0.94

$8.93

0.1×

Normal range

90651Normal range

HPV vaccine, 9-valent

$2K

2,057 claims · 0.0%

Your Cost: $0.94/claim|Median: $8.93

0.1× median

99214Office/outpatient visit, est. patient, mod-high complexitySee all providers →

$2K

8,843 claims

$0.19

$53.41

0.0×

Normal range

99214Normal range

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

$2K

8,843 claims · 0.0%

Your Cost: $0.19/claim|Median: $53.41

0.0× median

90633 See all providers →

$2K

2,075 claims

$0.78

$3.56

0.2×

Normal range

90633Normal range

$2K

2,075 claims · 0.0%

Your Cost: $0.78/claim|Median: $3.56

0.2× median

90707MMR vaccineSee all providers →

$1K

422 claims

$2.97

$5.76

0.5×

Normal range

90707Normal range

MMR vaccine

$1K

422 claims · 0.0%

Your Cost: $2.97/claim|Median: $5.76

0.5× median

90792Psychiatric diagnostic evaluation with medical servicesSee all providers →

$1K

3,106 claims

$0.38

$108.91

0.0×

Normal range

90792Normal range

Psychiatric diagnostic evaluation with medical services

$1K

3,106 claims · 0.0%

Your Cost: $0.38/claim|Median: $108.91

0.0× median

90674 See all providers →

$741

1,121 claims

$0.66

$15.16

0.0×

Normal range

90674Normal range

$741

1,121 claims · 0.0%

Your Cost: $0.66/claim|Median: $15.16

0.0× median

0124A See all providers →

$711

20 claims

$35.53

$34.32

1.0×

Normal range

0124ANormal range

$711

20 claims · 0.0%

Your Cost: $35.53/claim|Median: $34.32

1.0× median

99393Preventive medicine, established patient, age 5-11See all providers →

$692

3,184 claims

$0.22

$74.82

0.0×

Normal range

99393Normal range

Preventive medicine, established patient, age 5-11

$692

3,184 claims · 0.0%

Your Cost: $0.22/claim|Median: $74.82

0.0× median

90715Tdap vaccineSee all providers →

$641

780 claims

$0.82

$10.32

0.1×

Normal range

90715Normal range

Tdap vaccine

$641

780 claims · 0.0%

Your Cost: $0.82/claim|Median: $10.32

0.1× median

0002ACOVID-19 vaccine admin, Pfizer, 2nd doseSee all providers →

$620

18 claims

$34.43

$36.70

0.9×

Normal range

0002ANormal range

COVID-19 vaccine admin, Pfizer, 2nd dose

$620

18 claims · 0.0%

Your Cost: $34.43/claim|Median: $36.70

0.9× median

99392Preventive medicine, established patient, age 1-4See all providers →

$609

3,548 claims

$0.17

$75.18

0.0×

Normal range

99392Normal range

Preventive medicine, established patient, age 1-4

$609

3,548 claims · 0.0%

Your Cost: $0.17/claim|Median: $75.18

0.0× median

90670 See all providers →

$558

2,344 claims

$0.24

$5.94

0.0×

Normal range

90670Normal range

$558

2,344 claims · 0.0%

Your Cost: $0.24/claim|Median: $5.94

0.0× median

0071A See all providers →

$506

12 claims

$42.14

$38.71

1.1×

Top 25%

0071ATop 25%

$506

12 claims · 0.0%

Your Cost: $42.14/claim|Median: $38.71

1.1× median

S5190Wellness assessment, performed by non-physicianSee all providers →

$460

311 claims

$1.48

$33.67

0.0×

Normal range

S5190Normal range

Wellness assessment, performed by non-physician

$460

311 claims · 0.0%

Your Cost: $1.48/claim|Median: $33.67

0.0× median

90723DTaP-HepB-IPV vaccineSee all providers →

$359

1,321 claims

$0.27

$5.78

0.0×

Normal range

90723Normal range

DTaP-HepB-IPV vaccine

$359

1,321 claims · 0.0%

Your Cost: $0.27/claim|Median: $5.78

0.0× median

99391Preventive medicine, established patient, infant (under 1)See all providers →

$348

3,084 claims

$0.11

$69.35

0.0×

Normal range

99391Normal range

Preventive medicine, established patient, infant (under 1)

$348

3,084 claims · 0.0%

Your Cost: $0.11/claim|Median: $69.35

0.0× median

90834Psychotherapy, 45 minutesSee all providers →

$323

7,889 claims

$0.04

$63.65

0.0×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$323

7,889 claims · 0.0%

Your Cost: $0.04/claim|Median: $63.65

0.0× median

0500F See all providers →

$265

1,002 claims

$0.26

$39.34

0.0×

Normal range

0500FNormal range

$265

1,002 claims · 0.0%

Your Cost: $0.26/claim|Median: $39.34

0.0× median

0502F See all providers →

$265

5,497 claims

$0.05

$44.10

0.0×

Normal range

0502FNormal range

$265

5,497 claims · 0.0%

Your Cost: $0.05/claim|Median: $44.10

0.0× median

99203Office/outpatient visit, new patient, low-mod complexitySee all providers →

$252

2,247 claims

$0.11

$57.85

0.0×

Normal range

99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$252

2,247 claims · 0.0%

Your Cost: $0.11/claim|Median: $57.85

0.0× median

96110Developmental screening, per standardized instrumentSee all providers →

$225

2,116 claims

$0.11

$9.10

0.0×

Normal range

96110Normal range

Developmental screening, per standardized instrument

$225

2,116 claims · 0.0%

Your Cost: $0.11/claim|Median: $9.10

0.0× median

0001ACOVID-19 vaccine admin, Pfizer, 1st doseSee all providers →

$220

13 claims

$16.94

$33.72

0.5×

Normal range

0001ANormal range

COVID-19 vaccine admin, Pfizer, 1st dose

$220

13 claims · 0.0%

Your Cost: $16.94/claim|Median: $33.72

0.5× median

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