Is Provider 1790297216 flagged for Medicaid fraud?

Provider 1790297216 (NPI: 1790297216) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does Provider 1790297216 bill Medicaid?

Provider 1790297216 received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records.

What is NPI 1790297216?

NPI 1790297216 is the National Provider Identifier for Provider 1790297216.. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

Provider 1790297216

NPI: 1790297216Share

Active Billing Period:2018-03→2024-12(82 months)

Total Paid

$11.5M

$11,538,477

Total Claims

451K

Beneficiaries

247K

1.8 claims/patient

Avg Cost/Claim

$26

Monthly Spending Trend

Yearly Spending

2018

$188K

+713%

2019

$1.5M

+51%

2020

$2.3M

+20%

2021

$2.8M

-12%

2022

$2.4M

-43%

2023

$1.4M

-30%

2024

$962K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 28 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 53% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

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

$6.1M

85K claims

$72.12

$53.41

1.4×

Normal range

99214Normal range

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

$6.1M

85K claims · 53.1%

Your Cost: $72.12/claim|Median: $53.41

1.4× median

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

$1.3M

24K claims

$54.74

$37.81

1.4×

Top 25%

99213Top 25%

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

$1.3M

24K claims · 11.4%

Your Cost: $54.74/claim|Median: $37.81

1.4× median

80305 See all providers →

$1.1M

122K claims

$9.12

$7.44

1.2×

Normal range

80305Normal range

$1.1M

122K claims · 9.7%

Your Cost: $9.12/claim|Median: $7.44

1.2× median

99212Office/outpatient visit, low complexitySee all providers →

$764K

20K claims

$38.14

$25.06

1.5×

Top 25%

99212Top 25%

Office/outpatient visit, low complexity

$764K

20K claims · 6.6%

Your Cost: $38.14/claim|Median: $25.06

1.5× median

90832Psychotherapy, 30 minutesSee all providers →

$744K

16K claims

$47.53

$41.28

1.2×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$744K

16K claims · 6.4%

Your Cost: $47.53/claim|Median: $41.28

1.2× median

90834Psychotherapy, 45 minutesSee all providers →

$458K

7,938 claims

$57.73

$63.65

0.9×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$458K

7,938 claims · 4.0%

Your Cost: $57.73/claim|Median: $63.65

0.9× median

81025Urine pregnancy testSee all providers →

$292K

48K claims

$6.05

$4.81

1.3×

Normal range

81025Normal range

Urine pregnancy test

$292K

48K claims · 2.5%

Your Cost: $6.05/claim|Median: $4.81

1.3× median

90837Psychotherapy, 60 minutesSee all providers →

$237K

2,999 claims

$78.90

$85.66

0.9×

Normal range

90837Normal range

Psychotherapy, 60 minutes

$237K

2,999 claims · 2.1%

Your Cost: $78.90/claim|Median: $85.66

0.9× median

J2315 See all providers →

$220K

277 claims

$795.21

$1,045.36

0.8×

Normal range

J2315Normal range

$220K

277 claims · 1.9%

Your Cost: $795.21/claim|Median: $1,045.36

0.8× median

99215Office/outpatient visit, high complexitySee all providers →

$114K

1,073 claims

$106.30

$74.09

1.4×

Normal range

99215Normal range

Office/outpatient visit, high complexity

$114K

1,073 claims · 1.0%

Your Cost: $106.30/claim|Median: $74.09

1.4× median

99205Office/outpatient visit, new patient, high complexitySee all providers →

$55K

727 claims

$76.17

$111.09

0.7×

Normal range

99205Normal range

Office/outpatient visit, new patient, high complexity

$55K

727 claims · 0.5%

Your Cost: $76.17/claim|Median: $111.09

0.7× median

99211Office/outpatient visit, minimal complexitySee all providers →

$32K

2,002 claims

$16.04

$12.93

1.2×

Normal range

99211Normal range

Office/outpatient visit, minimal complexity

$32K

2,002 claims · 0.3%

Your Cost: $16.04/claim|Median: $12.93

1.2× median

94760Pulse oximetry, single reading, noninvasiveSee all providers →

$25K

116K claims

$0.22

$0.79

0.3×

Normal range

94760Normal range

Pulse oximetry, single reading, noninvasive

$25K

116K claims · 0.2%

Your Cost: $0.22/claim|Median: $0.79

0.3× median

99492 See all providers →

$14K

145 claims

$94.04

$68.72

1.4×

Normal range

99492Normal range

$14K

145 claims · 0.1%

Your Cost: $94.04/claim|Median: $68.72

1.4× median

90792Psychiatric diagnostic evaluation with medical servicesSee all providers →

$6K

49 claims

$131.79

$108.91

1.2×

Normal range

90792Normal range

Psychiatric diagnostic evaluation with medical services

$6K

49 claims · 0.1%

Your Cost: $131.79/claim|Median: $108.91

1.2× median

90791Psychiatric diagnostic evaluationSee all providers →

$5K

56 claims

$95.01

$99.21

1.0×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$5K

56 claims · 0.0%

Your Cost: $95.01/claim|Median: $99.21

1.0× median

36415Collection of venous blood by venipunctureSee all providers →

$5K

1,216 claims

$3.78

$1.57

2.4×

Top 25%

36415Top 25%

Collection of venous blood by venipuncture

$5K

1,216 claims · 0.0%

Your Cost: $3.78/claim|Median: $1.57

2.4× median

96372Therapeutic injection, subcutaneous/intramuscularSee all providers →

$4K

839 claims

$4.57

$9.56

0.5×

Normal range

96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$4K

839 claims · 0.0%

Your Cost: $4.57/claim|Median: $9.56

0.5× median

99407 See all providers →

$2K

1,282 claims

$1.24

$13.29

0.1×

Normal range

99407Normal range

$2K

1,282 claims · 0.0%

Your Cost: $1.24/claim|Median: $13.29

0.1× median

0031ACOVID-19 vaccine admin, J&J, single doseSee all providers →

$2K

54 claims

$28.56

$32.49

0.9×

Normal range

0031ANormal range

COVID-19 vaccine admin, J&J, single dose

$2K

54 claims · 0.0%

Your Cost: $28.56/claim|Median: $32.49

0.9× median

99000 See all providers →

$1K

606 claims

$2.24

$2.30

1.0×

Normal range

99000Normal range

$1K

606 claims · 0.0%

Your Cost: $2.24/claim|Median: $2.30

1.0× median

90836Psychotherapy, 45 min, add-on to E/MSee all providers →

$1K

64 claims

$18.37

$56.18

0.3×

Normal range

90836Normal range

Psychotherapy, 45 min, add-on to E/M

$1K

64 claims · 0.0%

Your Cost: $18.37/claim|Median: $56.18

0.3× median

G0444Annual depression screening, fifteen minutesSee all providers →

$363

703 claims

$0.52

$4.23

0.1×

Normal range

G0444Normal range

Annual depression screening, fifteen minutes

$363

703 claims · 0.0%

Your Cost: $0.52/claim|Median: $4.23

0.1× median

99001 See all providers →

$90

79 claims

$1.14

$2.31

0.5×

Normal range

99001Normal range

$90

79 claims · 0.0%

Your Cost: $1.14/claim|Median: $2.31

0.5× median

90471Immunization administration, 1 vaccine, percutaneous/ID/SC/IMSee all providers →

17 claims

$0.00

$9.80

—

Normal range

90471Normal range

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

17 claims · 0.0%

Your Cost: $0.00/claim|Median: $9.80

90674 See all providers →

15 claims

$0.00

$15.16

—

Normal range

90674Normal range

15 claims · 0.0%

Your Cost: $0.00/claim|Median: $15.16

90632 See all providers →

16 claims

$0.00

$40.43

—

Normal range

90632Normal range

16 claims · 0.0%

Your Cost: $0.00/claim|Median: $40.43

91303COVID-19 vaccine (J&J/Janssen), single doseSee all providers →

49 claims

$0.00

$0.01

—

Normal range

91303Normal range

COVID-19 vaccine (J&J/Janssen), single dose

49 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.01

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