Is Provider 1861538209 flagged for Medicaid fraud?

Provider 1861538209 (NPI: 1861538209) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does Provider 1861538209 bill Medicaid?

Provider 1861538209 received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records.

What is NPI 1861538209?

NPI 1861538209 is the National Provider Identifier for Provider 1861538209.. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

Provider 1861538209

NPI: 1861538209Share

Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$17.9M

$17,923,424

Total Claims

192K

Beneficiaries

47K

4.1 claims/patient

Avg Cost/Claim

$94

Monthly Spending Trend

Yearly Spending

2018

$3.7M

+7%

2019

$4.0M

-27%

2020

$2.9M

-37%

2021

$1.8M

+34%

2022

$2.4M

-16%

2023

$2.0M

-44%

2024

$1.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 11 distinct procedure codes. The top code (Q5001 (Injection, filgrastim-sndz, biosimilar, 1 mcg)) accounts for 79% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

Q5001Injection, filgrastim-sndz, biosimilar, 1 mcgSee all providers →

$14.2M

50K claims

$285.77

$23.43

12.2×

Top 25%

Q5001Top 25%

Injection, filgrastim-sndz, biosimilar, 1 mcg

$14.2M

50K claims · 79.5%

Your Cost: $285.77/claim|Median: $23.43

12.2× median

Q5005 See all providers →

$2.4M

2,987 claims

$799.23

$432.46

1.8×

Top 25%

Q5005Top 25%

$2.4M

2,987 claims · 13.3%

Your Cost: $799.23/claim|Median: $432.46

1.8× median

Q5006 See all providers →

$1.3M

1,987 claims

$640.01

$544.82

1.2×

Normal range

Q5006Normal range

$1.3M

1,987 claims · 7.1%

Your Cost: $640.01/claim|Median: $544.82

1.2× median

G0299Skilled nursing services, home health, per visit, RNSee all providers →

$17K

51K claims

$0.34

$51.67

0.0×

Normal range

G0299Normal range

Skilled nursing services, home health, per visit, RN

$17K

51K claims · 0.1%

Your Cost: $0.34/claim|Median: $51.67

0.0× median

Q5003Injection, infliximab-dyyb, biosimilar, 10 mgSee all providers →

$4K

7,048 claims

$0.51

$177.99

0.0×

Normal range

Q5003Normal range

Injection, infliximab-dyyb, biosimilar, 10 mg

$4K

7,048 claims · 0.0%

Your Cost: $0.51/claim|Median: $177.99

0.0× median

99232Subsequent hospital care, per day, moderate complexitySee all providers →

$2K

237 claims

$6.57

$23.99

0.3×

Normal range

99232Normal range

Subsequent hospital care, per day, moderate complexity

$2K

237 claims · 0.0%

Your Cost: $6.57/claim|Median: $23.99

0.3× median

G0155Services of clinical social worker in home health, per 15 minSee all providers →

$868

15K claims

$0.06

$7.04

0.0×

Normal range

G0155Normal range

Services of clinical social worker in home health, per 15 min

$868

15K claims · 0.0%

Your Cost: $0.06/claim|Median: $7.04

0.0× median

J2060Injection, lorazepam, two milligramsSee all providers →

46 claims

$0.00

$0.62

—

Normal range

J2060Normal range

Injection, lorazepam, two milligrams

46 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.62

99222Initial hospital care, per day, moderate complexitySee all providers →

41 claims

$0.00

$51.25

—

Normal range

99222Normal range

Initial hospital care, per day, moderate complexity

41 claims · 0.0%

Your Cost: $0.00/claim|Median: $51.25

G0156Home health aide services, per visitSee all providers →

60K claims

$0.00

$39.42

—

Normal range

G0156Normal range

Home health aide services, per visit

60K claims · 0.0%

Your Cost: $0.00/claim|Median: $39.42

G0300Skilled nursing services, home health, per visit, LPNSee all providers →

3,388 claims

$0.00

$45.50

—

Normal range

G0300Normal range

Skilled nursing services, home health, per visit, LPN

3,388 claims · 0.0%

Your Cost: $0.00/claim|Median: $45.50

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