Is Provider 1861906687 flagged for Medicaid fraud?

Provider 1861906687 (NPI: 1861906687) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does Provider 1861906687 bill Medicaid?

Provider 1861906687 received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records.

What is NPI 1861906687?

NPI 1861906687 is the National Provider Identifier for Provider 1861906687.. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

Provider 1861906687

NPI: 1861906687Share

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$16.8M

$16,798,164

Total Claims

174K

Beneficiaries

52K

3.4 claims/patient

Avg Cost/Claim

$97

Monthly Spending Trend

Yearly Spending

2018

$1.1M

+43%

2019

$1.6M

+19%

2020

$1.9M

+28%

2021

$2.4M

+25%

2022

$3.0M

+13%

2023

$3.4M

-1%

2024

$3.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 18 distinct procedure codes. The top code (H0020 (Alcohol/drug services; methadone administration)) accounts for 96% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H0020Alcohol/drug services; methadone administrationSee all providers →

$16.1M

157K claims

$102.73

$18.95

5.4×

Top 10%

H0020Top 10%

Alcohol/drug services; methadone administration

$16.1M

157K claims · 95.8%

Your Cost: $102.73/claim|Median: $18.95

5.4× median

99212Office/outpatient visit, low complexitySee all providers →

$172K

4,620 claims

$37.17

$25.06

1.5×

Top 25%

99212Top 25%

Office/outpatient visit, low complexity

$172K

4,620 claims · 1.0%

Your Cost: $37.17/claim|Median: $25.06

1.5× median

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

$158K

2,646 claims

$59.72

$37.81

1.6×

Top 25%

99213Top 25%

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

$158K

2,646 claims · 0.9%

Your Cost: $59.72/claim|Median: $37.81

1.6× median

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

$147K

1,758 claims

$83.51

$53.41

1.6×

Top 25%

99214Top 25%

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

$147K

1,758 claims · 0.9%

Your Cost: $83.51/claim|Median: $53.41

1.6× median

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

$98K

687 claims

$142.17

$111.09

1.3×

Normal range

99205Normal range

Office/outpatient visit, new patient, high complexity

$98K

687 claims · 0.6%

Your Cost: $142.17/claim|Median: $111.09

1.3× median

99215Office/outpatient visit, high complexitySee all providers →

$59K

581 claims

$101.79

$74.09

1.4×

Normal range

99215Normal range

Office/outpatient visit, high complexity

$59K

581 claims · 0.4%

Your Cost: $101.79/claim|Median: $74.09

1.4× median

H0031Mental health assessment by non-physicianSee all providers →

$27K

288 claims

$93.00

$96.18

1.0×

Normal range

H0031Normal range

Mental health assessment by non-physician

$27K

288 claims · 0.2%

Your Cost: $93.00/claim|Median: $96.18

1.0× median

T1001Nursing assessment/evaluation, per visitSee all providers →

$12K

1,484 claims

$7.90

$49.05

0.2×

Normal range

T1001Normal range

Nursing assessment/evaluation, per visit

$12K

1,484 claims · 0.1%

Your Cost: $7.90/claim|Median: $49.05

0.2× median

G2067Medication-assisted treatment, opioid use disorder, per monthSee all providers →

$9K

2,238 claims

$3.91

$73.29

0.1×

Normal range

G2067Normal range

Medication-assisted treatment, opioid use disorder, per month

$9K

2,238 claims · 0.1%

Your Cost: $3.91/claim|Median: $73.29

0.1× median

86580Tuberculosis (TB) skin testSee all providers →

$6K

1,736 claims

$3.36

$4.46

0.8×

Normal range

86580Normal range

Tuberculosis (TB) skin test

$6K

1,736 claims · 0.0%

Your Cost: $3.36/claim|Median: $4.46

0.8× median

80074 See all providers →

$3K

69 claims

$48.33

$27.54

1.8×

Top 25%

80074Top 25%

$3K

69 claims · 0.0%

Your Cost: $48.33/claim|Median: $27.54

1.8× median

81025Urine pregnancy testSee all providers →

$3K

707 claims

$4.37

$4.81

0.9×

Normal range

81025Normal range

Urine pregnancy test

$3K

707 claims · 0.0%

Your Cost: $4.37/claim|Median: $4.81

0.9× median

99211Office/outpatient visit, minimal complexitySee all providers →

$2K

138 claims

$14.74

$12.93

1.1×

Normal range

99211Normal range

Office/outpatient visit, minimal complexity

$2K

138 claims · 0.0%

Your Cost: $14.74/claim|Median: $12.93

1.1× median

86689 See all providers →

$1K

69 claims

$19.64

$11.89

1.7×

Normal range

86689Normal range

$1K

69 claims · 0.0%

Your Cost: $19.64/claim|Median: $11.89

1.7× median

80076Hepatic function panelSee all providers →

$572

69 claims

$8.29

$4.59

1.8×

Top 25%

80076Top 25%

Hepatic function panel

$572

69 claims · 0.0%

Your Cost: $8.29/claim|Median: $4.59

1.8× median

86592 See all providers →

$299

69 claims

$4.33

$3.35

1.3×

Top 25%

86592Top 25%

$299

69 claims · 0.0%

Your Cost: $4.33/claim|Median: $3.35

1.3× median

36415Collection of venous blood by venipunctureSee all providers →

70 claims

$0.04

$1.57

0.0×

Normal range

36415Normal range

Collection of venous blood by venipuncture

70 claims · 0.0%

Your Cost: $0.04/claim|Median: $1.57

0.0× median

80307Drug test, presumptive, by chemistry analyzersSee all providers →

69 claims

$0.00

$35.43

—

Normal range

80307Normal range

Drug test, presumptive, by chemistry analyzers

69 claims · 0.0%

Your Cost: $0.00/claim|Median: $35.43

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