Total Paid
$186K
$185,980
Total Claims
2,484
Beneficiaries
2,017
1.2 claims/patient
Avg Cost/Claim
$75
🔍 Analysis
Provider Overview
is a Medicaid provider based in Unknown location. From 2018-01 through 2018-08, this provider received $186K in Medicaid payments across 2K claims serving 2K beneficiaries, billing 5 distinct procedure codes.
Key Findings
- 📊Bills 24.2× the national median for A4253 (A4253), at $168 per claim vs. the median of $7. This places them well above the 99th percentile nationally.
- 📊83% of billing is concentrated in A4253 (A4253), indicating significant specialization in this service.
- 📊Billing stopped in 2018-08, suggesting this provider is no longer active in Medicaid.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 (A4253 (Blood glucose test strips)) accounts for 83% of total spending.
ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile
A4253Top 1%
Blood glucose test strips
$154K
918 claims · 82.8%
Your Cost: $167.75/claim|Median: $6.92
24.2× medianA4259Top 5%
Lancets for blood glucose testing
$15K
851 claims · 8.3%
Your Cost: $18.04/claim|Median: $2.27
7.9× medianA4215Normal range
Sterile needle, each
$7K
267 claims · 4.0%
Your Cost: $27.73/claim|Median: $20.71
1.3× medianS8490Top 5%
$7K
120 claims · 3.7%
Your Cost: $57.05/claim|Median: $22.06
2.6× medianA4256Top 10%
$2K
328 claims · 1.3%
Your Cost: $7.28/claim|Median: $2.85
2.6× median