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

⚖️ Compare🖨️ Print Report

Provider 1699718528

NPI: 1699718528Share
Active Billing Period:2018-01→2024-12(56 months)

Total Paid

$17.4M

$17,367,714

Total Claims

119K

Beneficiaries

14K

8.2 claims/patient

Avg Cost/Claim

$146

Monthly Spending Trend

Yearly Spending

2018
$10K
+5%
2019
$11K
-75%
2020
$3K
+108452%
2021
$2.9M
+66%
2022
$4.8M
-2%
2023
$4.7M
+7%
2024
$5.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 27 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 62% of total spending.

H2016Normal range

Comprehensive community support services, per 15 min

$10.8M

15K claims · 62.1%

Your Cost: $725.91/claim|Median: $321.53
2.3× median
M0166Normal range

$1.5M

10K claims · 8.4%

Your Cost: $142.96/claim|Median: $151.35
0.9× median
H2014Normal range

Skills training & development, per 15 min

$1.2M

30K claims · 7.1%

Your Cost: $40.33/claim|Median: $83.88
0.5× median
M0167Normal range

$1.1M

7,453 claims · 6.5%

Your Cost: $151.64/claim|Median: $158.84
1.0× median
M0123Top 1%

$683K

8,975 claims · 3.9%

Your Cost: $76.14/claim|Median: $76.14
1.0× median
T2020Normal range

Day habilitation, waiver; per diem

$515K

4,047 claims · 3.0%

Your Cost: $127.27/claim|Median: $87.34
1.5× median
M0116Normal range

$355K

12K claims · 2.0%

Your Cost: $29.62/claim|Median: $32.07
0.9× median
M0122Top 1%

$340K

4,691 claims · 2.0%

Your Cost: $72.56/claim|Median: $72.56
1.0× median
M0115Normal range

$313K

12K claims · 1.8%

Your Cost: $26.29/claim|Median: $29.58
0.9× median
T1002Normal range

RN services, per 15 minutes

$148K

2,939 claims · 0.9%

Your Cost: $50.41/claim|Median: $37.42
1.3× median
T1003Normal range

LPN/LVN services, per 15 minutes

$113K

5,187 claims · 0.6%

Your Cost: $21.72/claim|Median: $24.24
0.9× median
D0120Top 1%

Periodic oral evaluation, established patient

$93K

364 claims · 0.5%

Your Cost: $256.65/claim|Median: $24.34
10.5× median
H2019Normal range

Therapeutic behavioral services, per 15 min

$81K

1,580 claims · 0.5%

Your Cost: $51.24/claim|Median: $84.12
0.6× median
D4355Normal range

$21K

299 claims · 0.1%

Your Cost: $69.92/claim|Median: $64.42
1.1× median
M0113Normal range

$20K

44 claims · 0.1%

Your Cost: $453.25/claim|Median: $397.30
1.1× median
M0299Normal range

$18K

475 claims · 0.1%

Your Cost: $37.96/claim|Median: $34.98
1.1× median
M0298Top 5%

$13K

420 claims · 0.1%

Your Cost: $31.92/claim|Median: $13.85
2.3× median
D9920Normal range

$9K

191 claims · 0.1%

Your Cost: $47.67/claim|Median: $44.88
1.1× median
M0101Normal range

$7K

224 claims · 0.0%

Your Cost: $33.18/claim|Median: $65.66
0.5× median
A9153Normal range

$6K

659 claims · 0.0%

Your Cost: $9.47/claim|Median: $45.63
0.2× median
M0315Normal range

$6K

170 claims · 0.0%

Your Cost: $34.73/claim|Median: $29.80
1.2× median
90832Normal range

Psychotherapy, 30 minutes

$6K

171 claims · 0.0%

Your Cost: $34.06/claim|Median: $41.28
0.8× median
H2026Normal range

$6K

154 claims · 0.0%

Your Cost: $36.11/claim|Median: $76.18
0.5× median
90837Normal range

Psychotherapy, 60 minutes

$5K

109 claims · 0.0%

Your Cost: $43.24/claim|Median: $85.66
0.5× median
D0274Top 25%

Bitewings, four radiographic images

$3K

89 claims · 0.0%

Your Cost: $30.75/claim|Median: $22.54
1.4× median
M0248Normal range

$2K

899 claims · 0.0%

Your Cost: $2.04/claim|Median: $5.31
0.4× median
D0603Normal range

$0

131 claims · 0.0%

Your Cost: $0.00/claim|Median: $6.54
← All providersHow we detect fraud →