Is WALLOON LAKE RECOVERY LODGE, LLC flagged for Medicaid fraud?

WALLOON LAKE RECOVERY LODGE, LLC (NPI: 1750791505) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does WALLOON LAKE RECOVERY LODGE, LLC bill Medicaid?

WALLOON LAKE RECOVERY LODGE, LLC received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Substance Abuse Rehabilitation Facility provider. Located in BOYNE FALLS, MI.

What is NPI 1750791505?

NPI 1750791505 is the National Provider Identifier for WALLOON LAKE RECOVERY LODGE, LLC. They are a Substance Abuse Rehabilitation Facility provider based in BOYNE FALLS, MI. This NPI is registered with the CMS NPI Registry.

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WALLOON LAKE RECOVERY LODGE, LLC

Substance Abuse Rehabilitation Facility·BOYNE FALLS, MI·NPI: 1750791505Share

Compared to Substance Abuse Rehabilitation Facility Peers

Total spending distribution among 20 providers in this specialty

P25MedianP75P90

This provider's total spending of $23.3M is at the 25th percentile among 20 Substance Abuse Rehabilitation Facility providers.

Active Billing Period:2019-04→2024-12(67 months)

Total Paid

$23.3M

$23,299,190

Total Claims

70K

Beneficiaries

27K

2.6 claims/patient

Avg Cost/Claim

$334

Monthly Spending Trend

Yearly Spending

2019

$458K

+402%

2020

$2.3M

+71%

2021

$3.9M

+15%

2022

$4.5M

+17%

2023

$5.3M

+28%

2024

$6.8M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 19 distinct procedure codes. The top code (H0019 (Behavioral health; residential, per diem)) accounts for 66% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H0019Behavioral health; residential, per diemSee all providers →

$15.3M

19K claims

$800.11

$357.16

2.2×

Normal range

H0019Normal range

Behavioral health; residential, per diem

$15.3M

19K claims · 65.8%

Your Cost: $800.11/claim|Median: $357.16

2.2× median

S9976 See all providers →

$2.4M

22K claims

$110.63

$64.43

1.7×

Normal range

S9976Normal range

$2.4M

22K claims · 10.4%

Your Cost: $110.63/claim|Median: $64.43

1.7× median

H0010Alcohol and/or drug services, sub-acute detoxification, per diemSee all providers →

$2.3M

2,589 claims

$871.36

$369.55

2.4×

Top 25%

H0010Top 25%

Alcohol and/or drug services, sub-acute detoxification, per diem

$2.3M

2,589 claims · 9.7%

Your Cost: $871.36/claim|Median: $369.55

2.4× median

90837Psychotherapy, 60 minutesSee all providers →

$1.2M

9,374 claims

$127.25

$85.66

1.5×

Top 10%

90837Top 10%

Psychotherapy, 60 minutes

$1.2M

9,374 claims · 5.1%

Your Cost: $127.25/claim|Median: $85.66

1.5× median

S0280Medical home program, comprehensive care managementSee all providers →

$507K

3,095 claims

$163.86

$48.38

3.4×

Top 25%

S0280Top 25%

Medical home program, comprehensive care management

$507K

3,095 claims · 2.2%

Your Cost: $163.86/claim|Median: $48.38

3.4× median

H0012 See all providers →

$405K

462 claims

$875.60

$295.95

3.0×

Top 5%

H0012Top 5%

$405K

462 claims · 1.7%

Your Cost: $875.60/claim|Median: $295.95

3.0× median

90853Group psychotherapySee all providers →

$310K

4,391 claims

$70.54

$25.02

2.8×

Top 10%

90853Top 10%

Group psychotherapy

$310K

4,391 claims · 1.3%

Your Cost: $70.54/claim|Median: $25.02

2.8× median

H0004Behavioral health counseling & therapy, per 15 minSee all providers →

$287K

2,696 claims

$106.49

$74.63

1.4×

Top 25%

H0004Top 25%

Behavioral health counseling & therapy, per 15 min

$287K

2,696 claims · 1.2%

Your Cost: $106.49/claim|Median: $74.63

1.4× median

H0018Behavioral health; short-term residential, per diemSee all providers →

$250K

369 claims

$676.62

$467.51

1.4×

Normal range

H0018Normal range

Behavioral health; short-term residential, per diem

$250K

369 claims · 1.1%

Your Cost: $676.62/claim|Median: $467.51

1.4× median

H0002Behavioral health screeningSee all providers →

$88K

1,806 claims

$48.85

$38.77

1.3×

Normal range

H0002Normal range

Behavioral health screening

$88K

1,806 claims · 0.4%

Your Cost: $48.85/claim|Median: $38.77

1.3× median

S0215Non-invasive prenatal screening, fetal chromosomal abnormalitiesSee all providers →

$58K

1,043 claims

$55.73

$21.33

2.6×

Top 25%

S0215Top 25%

Non-invasive prenatal screening, fetal chromosomal abnormalities

$58K

1,043 claims · 0.2%

Your Cost: $55.73/claim|Median: $21.33

2.6× median

H0006Alcohol and/or drug services, case managementSee all providers →

$49K

1,736 claims

$28.35

$43.10

0.7×

Normal range

H0006Normal range

Alcohol and/or drug services, case management

$49K

1,736 claims · 0.2%

Your Cost: $28.35/claim|Median: $43.10

0.7× median

T1007Alcohol/drug services, treatment plan reviewSee all providers →

$35K

355 claims

$98.98

$64.10

1.5×

Normal range

T1007Normal range

Alcohol/drug services, treatment plan review

$35K

355 claims · 0.2%

Your Cost: $98.98/claim|Median: $64.10

1.5× median

H0001Alcohol and/or drug assessmentSee all providers →

$25K

100 claims

$252.38

$94.22

2.7×

Top 5%

H0001Top 5%

Alcohol and/or drug assessment

$25K

100 claims · 0.1%

Your Cost: $252.38/claim|Median: $94.22

2.7× median

H2036Alcohol/drug treatment, per hourSee all providers →

$22K

26 claims

$852.62

$253.79

3.4×

Top 25%

H2036Top 25%

Alcohol/drug treatment, per hour

$22K

26 claims · 0.1%

Your Cost: $852.62/claim|Median: $253.79

3.4× median

H2034Alcohol and/or drug abuse halfway house services, per hourSee all providers →

$16K

60 claims

$262.28

$164.03

1.6×

Top 25%

H2034Top 25%

Alcohol and/or drug abuse halfway house services, per hour

$16K

60 claims · 0.1%

Your Cost: $262.28/claim|Median: $164.03

1.6× median

H0038Self-help/peer services, per 15 minutesSee all providers →

$12K

152 claims

$79.99

$55.04

1.5×

Normal range

H0038Normal range

Self-help/peer services, per 15 minutes

$12K

152 claims · 0.1%

Your Cost: $79.99/claim|Median: $55.04

1.5× median

H0005Alcohol and/or drug services, group counselingSee all providers →

$11K

230 claims

$48.49

$47.35

1.0×

Normal range

H0005Normal range

Alcohol and/or drug services, group counseling

$11K

230 claims · 0.0%

Your Cost: $48.49/claim|Median: $47.35

1.0× median

90834Psychotherapy, 45 minutesSee all providers →

$6K

53 claims

$105.28

$63.65

1.7×

Top 25%

90834Top 25%

Psychotherapy, 45 minutes

$6K

53 claims · 0.0%

Your Cost: $105.28/claim|Median: $63.65

1.7× median

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