Is Provider 1942398367 flagged for Medicaid fraud?

Provider 1942398367 (NPI: 1942398367) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does Provider 1942398367 bill Medicaid?

Provider 1942398367 received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records.

What is NPI 1942398367?

NPI 1942398367 is the National Provider Identifier for Provider 1942398367.. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

Provider 1942398367

NPI: 1942398367Share

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

Total Paid

$15.2M

$15,219,635

Total Claims

428K

Beneficiaries

338K

1.3 claims/patient

Avg Cost/Claim

$36

Monthly Spending Trend

Yearly Spending

2018

$2.6M

-13%

2019

$2.2M

+14%

2020

$2.5M

+26%

2021

$3.2M

-4%

2022

$3.1M

-53%

2023

$1.4M

-87%

2024

$192K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 86% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1015Clinic visit/encounter, all-inclusiveSee all providers →

$13.0M

105K claims

$124.16

$121.16

1.0×

Normal range

T1015Normal range

Clinic visit/encounter, all-inclusive

$13.0M

105K claims · 85.6%

Your Cost: $124.16/claim|Median: $121.16

1.0× median

00003Anesthesia servicesSee all providers →

$1.4M

7,947 claims

$177.53

$223.77

0.8×

Normal range

00003Normal range

Anesthesia services

$1.4M

7,947 claims · 9.3%

Your Cost: $177.53/claim|Median: $223.77

0.8× median

G9012Other specified case management service, per 15 minutesSee all providers →

$235K

10K claims

$22.66

$137.85

0.2×

Normal range

G9012Normal range

Other specified case management service, per 15 minutes

$235K

10K claims · 1.5%

Your Cost: $22.66/claim|Median: $137.85

0.2× median

90834Psychotherapy, 45 minutesSee all providers →

$153K

5,731 claims

$26.74

$63.65

0.4×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$153K

5,731 claims · 1.0%

Your Cost: $26.74/claim|Median: $63.65

0.4× median

90837Psychotherapy, 60 minutesSee all providers →

$128K

2,885 claims

$44.38

$85.66

0.5×

Normal range

90837Normal range

Psychotherapy, 60 minutes

$128K

2,885 claims · 0.8%

Your Cost: $44.38/claim|Median: $85.66

0.5× median

H0043Supported housing, per diemSee all providers →

$95K

213 claims

$447.94

$164.87

2.7×

Top 25%

H0043Top 25%

Supported housing, per diem

$95K

213 claims · 0.6%

Your Cost: $447.94/claim|Median: $164.87

2.7× median

G0467Federally qualified health center visit, mental healthSee all providers →

$30K

1,508 claims

$19.66

$21.91

0.9×

Normal range

G0467Normal range

Federally qualified health center visit, mental health

$30K

1,508 claims · 0.2%

Your Cost: $19.66/claim|Median: $21.91

0.9× median

90853Group psychotherapySee all providers →

$28K

2,206 claims

$12.67

$25.02

0.5×

Normal range

90853Normal range

Group psychotherapy

$28K

2,206 claims · 0.2%

Your Cost: $12.67/claim|Median: $25.02

0.5× median

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

$26K

98K claims

$0.27

$37.81

0.0×

Normal range

99213Normal range

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

$26K

98K claims · 0.2%

Your Cost: $0.27/claim|Median: $37.81

0.0× median

92014Ophthalmological exam, comprehensive, established patientSee all providers →

$19K

2,897 claims

$6.57

$47.08

0.1×

Normal range

92014Normal range

Ophthalmological exam, comprehensive, established patient

$19K

2,897 claims · 0.1%

Your Cost: $6.57/claim|Median: $47.08

0.1× median

90832Psychotherapy, 30 minutesSee all providers →

$18K

1,093 claims

$16.52

$41.28

0.4×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$18K

1,093 claims · 0.1%

Your Cost: $16.52/claim|Median: $41.28

0.4× median

90791Psychiatric diagnostic evaluationSee all providers →

$12K

284 claims

$43.50

$99.21

0.4×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$12K

284 claims · 0.1%

Your Cost: $43.50/claim|Median: $99.21

0.4× median

90686Influenza virus vaccine, quadrivalent, preservative-free, IMSee all providers →

$7K

2,703 claims

$2.64

$7.18

0.4×

Normal range

90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$7K

2,703 claims · 0.0%

Your Cost: $2.64/claim|Median: $7.18

0.4× median

92004Ophthalmological exam, comprehensive, new patientSee all providers →

$5K

668 claims

$7.18

$59.72

0.1×

Normal range

92004Normal range

Ophthalmological exam, comprehensive, new patient

$5K

668 claims · 0.0%

Your Cost: $7.18/claim|Median: $59.72

0.1× median

92015Determination of refractive stateSee all providers →

$5K

3,345 claims

$1.37

$10.36

0.1×

Normal range

92015Normal range

Determination of refractive state

$5K

3,345 claims · 0.0%

Your Cost: $1.37/claim|Median: $10.36

0.1× median

G0511RHC/FQHC visit, psychiatric collaborative care modelSee all providers →

$4K

980 claims

$4.15

$11.35

0.4×

Normal range

G0511Normal range

RHC/FQHC visit, psychiatric collaborative care model

$4K

980 claims · 0.0%

Your Cost: $4.15/claim|Median: $11.35

0.4× median

99212Office/outpatient visit, low complexitySee all providers →

$4K

26K claims

$0.14

$25.06

0.0×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$4K

26K claims · 0.0%

Your Cost: $0.14/claim|Median: $25.06

0.0× median

G2025 See all providers →

$4K

193 claims

$18.15

$15.63

1.2×

Normal range

G2025Normal range

$4K

193 claims · 0.0%

Your Cost: $18.15/claim|Median: $15.63

1.2× median

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

$2K

8,655 claims

$0.17

$53.41

0.0×

Normal range

99214Normal range

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

$2K

8,655 claims · 0.0%

Your Cost: $0.17/claim|Median: $53.41

0.0× median

0011ACOVID-19 vaccine admin, Moderna, 1st doseSee all providers →

$820

403 claims

$2.03

$25.93

0.1×

Normal range

0011ANormal range

COVID-19 vaccine admin, Moderna, 1st dose

$820

403 claims · 0.0%

Your Cost: $2.03/claim|Median: $25.93

0.1× median

99394Preventive medicine, established patient, age 12-17See all providers →

$783

190 claims

$4.12

$80.15

0.1×

Normal range

99394Normal range

Preventive medicine, established patient, age 12-17

$783

190 claims · 0.0%

Your Cost: $4.12/claim|Median: $80.15

0.1× median

H2016Comprehensive community support services, per 15 minSee all providers →

$753

600 claims

$1.25

$321.53

0.0×

Normal range

H2016Normal range

Comprehensive community support services, per 15 min

$753

600 claims · 0.0%

Your Cost: $1.25/claim|Median: $321.53

0.0× median

D5899 See all providers →

$594

932 claims

$0.64

$30.31

0.0×

Normal range

D5899Normal range

$594

932 claims · 0.0%

Your Cost: $0.64/claim|Median: $30.31

0.0× median

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

$514

6,220 claims

$0.08

$9.80

0.0×

Normal range

90471Normal range

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

$514

6,220 claims · 0.0%

Your Cost: $0.08/claim|Median: $9.80

0.0× median

99409 See all providers →

$500

14 claims

$35.71

$34.77

1.0×

Normal range

99409Normal range

$500

14 claims · 0.0%

Your Cost: $35.71/claim|Median: $34.77

1.0× median

G0472 See all providers →

$491

1,337 claims

$0.37

$14.24

0.0×

Normal range

G0472Normal range

$491

1,337 claims · 0.0%

Your Cost: $0.37/claim|Median: $14.24

0.0× median

99393Preventive medicine, established patient, age 5-11See all providers →

$414

237 claims

$1.75

$74.82

0.0×

Normal range

99393Normal range

Preventive medicine, established patient, age 5-11

$414

237 claims · 0.0%

Your Cost: $1.75/claim|Median: $74.82

0.0× median

80053Comprehensive metabolic panelSee all providers →

$402

9,548 claims

$0.04

$7.24

0.0×

Normal range

80053Normal range

Comprehensive metabolic panel

$402

9,548 claims · 0.0%

Your Cost: $0.04/claim|Median: $7.24

0.0× median

87806 See all providers →

$392

1,096 claims

$0.36

$20.54

0.0×

Normal range

87806Normal range

$392

1,096 claims · 0.0%

Your Cost: $0.36/claim|Median: $20.54

0.0× median

86803Hepatitis C antibodySee all providers →

$344

3,674 claims

$0.09

$10.17

0.0×

Normal range

86803Normal range

Hepatitis C antibody

$344

3,674 claims · 0.0%

Your Cost: $0.09/claim|Median: $10.17

0.0× median

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