Is Provider 1942863667 flagged for Medicaid fraud?

Provider 1942863667 (NPI: 1942863667) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does Provider 1942863667 bill Medicaid?

Provider 1942863667 received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records.

What is NPI 1942863667?

NPI 1942863667 is the National Provider Identifier for Provider 1942863667.. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

Provider 1942863667

NPI: 1942863667Share

Active Billing Period:2020-02→2024-12(59 months)

Total Paid

$7.7M

$7,717,013

Total Claims

84K

Beneficiaries

54K

1.5 claims/patient

Avg Cost/Claim

$92

Monthly Spending Trend

Yearly Spending

2020

$275K

+340%

2021

$1.2M

+9%

2022

$1.3M

+94%

2023

$2.6M

-7%

2024

$2.4M

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 81% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1015Clinic visit/encounter, all-inclusiveSee all providers →

$6.3M

34K claims

$185.69

$121.16

1.5×

Top 25%

T1015Top 25%

Clinic visit/encounter, all-inclusive

$6.3M

34K claims · 81.4%

Your Cost: $185.69/claim|Median: $121.16

1.5× median

99212Office/outpatient visit, low complexitySee all providers →

$554K

18K claims

$31.03

$25.06

1.2×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$554K

18K claims · 7.2%

Your Cost: $31.03/claim|Median: $25.06

1.2× median

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

$296K

8,936 claims

$33.09

$37.81

0.9×

Normal range

99213Normal range

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

$296K

8,936 claims · 3.8%

Your Cost: $33.09/claim|Median: $37.81

0.9× median

59409Vaginal delivery onlySee all providers →

$267K

479 claims

$557.66

$619.91

0.9×

Normal range

59409Normal range

Vaginal delivery only

$267K

479 claims · 3.5%

Your Cost: $557.66/claim|Median: $619.91

0.9× median

59514Cesarean delivery onlySee all providers →

$104K

276 claims

$377.35

$452.80

0.8×

Normal range

59514Normal range

Cesarean delivery only

$104K

276 claims · 1.3%

Your Cost: $377.35/claim|Median: $452.80

0.8× median

59430 See all providers →

$73K

1,952 claims

$37.19

$80.32

0.5×

Normal range

59430Normal range

$73K

1,952 claims · 0.9%

Your Cost: $37.19/claim|Median: $80.32

0.5× median

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

$65K

1,921 claims

$34.08

$53.41

0.6×

Normal range

99214Normal range

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

$65K

1,921 claims · 0.8%

Your Cost: $34.08/claim|Median: $53.41

0.6× median

99203Office/outpatient visit, new patient, low-mod complexitySee all providers →

$20K

757 claims

$26.54

$57.85

0.5×

Normal range

99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$20K

757 claims · 0.3%

Your Cost: $26.54/claim|Median: $57.85

0.5× median

99202Office/outpatient visit, new patient, low complexitySee all providers →

$17K

570 claims

$29.49

$40.11

0.7×

Normal range

99202Normal range

Office/outpatient visit, new patient, low complexity

$17K

570 claims · 0.2%

Your Cost: $29.49/claim|Median: $40.11

0.7× median

99204Office/outpatient visit, new patient, mod-high complexitySee all providers →

$8K

300 claims

$25.58

$84.03

0.3×

Normal range

99204Normal range

Office/outpatient visit, new patient, mod-high complexity

$8K

300 claims · 0.1%

Your Cost: $25.58/claim|Median: $84.03

0.3× median

76811Ultrasound, pregnant uterus, detailed, single fetusSee all providers →

$7K

2,427 claims

$2.94

$106.79

0.0×

Normal range

76811Normal range

Ultrasound, pregnant uterus, detailed, single fetus

$7K

2,427 claims · 0.1%

Your Cost: $2.94/claim|Median: $106.79

0.0× median

99282Emergency dept visit, low complexitySee all providers →

$6K

224 claims

$27.47

$37.72

0.7×

Normal range

99282Normal range

Emergency dept visit, low complexity

$6K

224 claims · 0.1%

Your Cost: $27.47/claim|Median: $37.72

0.7× median

81003Urinalysis, automated without microscopySee all providers →

$5K

3,479 claims

$1.57

$1.48

1.1×

Normal range

81003Normal range

Urinalysis, automated without microscopy

$5K

3,479 claims · 0.1%

Your Cost: $1.57/claim|Median: $1.48

1.1× median

82951 See all providers →

$4K

2,031 claims

$1.89

$10.32

0.2×

Normal range

82951Normal range

$4K

2,031 claims · 0.0%

Your Cost: $1.89/claim|Median: $10.32

0.2× median

59025Fetal non-stress testSee all providers →

$4K

171 claims

$20.68

$26.45

0.8×

Normal range

59025Normal range

Fetal non-stress test

$4K

171 claims · 0.0%

Your Cost: $20.68/claim|Median: $26.45

0.8× median

59020 See all providers →

$1K

54 claims

$27.59

1.0×

Normal range

59020Normal range

$1K

54 claims · 0.0%

Your Cost: $27.59/claim|Median: $27.59

1.0× median

81025Urine pregnancy testSee all providers →

$1K

381 claims

$2.83

$4.81

0.6×

Normal range

81025Normal range

Urine pregnancy test

$1K

381 claims · 0.0%

Your Cost: $2.83/claim|Median: $4.81

0.6× median

82947Blood glucose level testSee all providers →

$1K

1,084 claims

$0.96

$2.38

0.4×

Normal range

82947Normal range

Blood glucose level test

$1K

1,084 claims · 0.0%

Your Cost: $0.96/claim|Median: $2.38

0.4× median

76815Ultrasound, pregnant uterus, limitedSee all providers →

$731

184 claims

$3.97

$36.79

0.1×

Normal range

76815Normal range

Ultrasound, pregnant uterus, limited

$731

184 claims · 0.0%

Your Cost: $3.97/claim|Median: $36.79

0.1× median

36410 See all providers →

$687

233 claims

$2.95

$5.72

0.5×

Normal range

36410Normal range

$687

233 claims · 0.0%

Your Cost: $2.95/claim|Median: $5.72

0.5× median

99221Initial hospital care, straightforward/lowSee all providers →

$603

12 claims

$50.23

$39.96

1.3×

Normal range

99221Normal range

Initial hospital care, straightforward/low

$603

12 claims · 0.0%

Your Cost: $50.23/claim|Median: $39.96

1.3× median

90715Tdap vaccineSee all providers →

$166

116 claims

$1.43

$10.32

0.1×

Normal range

90715Normal range

Tdap vaccine

$166

116 claims · 0.0%

Your Cost: $1.43/claim|Median: $10.32

0.1× median

96372Therapeutic injection, subcutaneous/intramuscularSee all providers →

$44

52 claims

$0.84

$9.56

0.1×

Normal range

96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$44

52 claims · 0.0%

Your Cost: $0.84/claim|Median: $9.56

0.1× median

82952 See all providers →

$39

412 claims

$0.10

$3.03

0.0×

Normal range

82952Normal range

$39

412 claims · 0.0%

Your Cost: $0.10/claim|Median: $3.03

0.0× median

82948 See all providers →

$25

94 claims

$0.26

$1.78

0.1×

Normal range

82948Normal range

$25

94 claims · 0.0%

Your Cost: $0.26/claim|Median: $1.78

0.1× median

85018 See all providers →

$24

175 claims

$0.14

$1.71

0.1×

Normal range

85018Normal range

$24

175 claims · 0.0%

Your Cost: $0.14/claim|Median: $1.71

0.1× median

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

130 claims

$0.00

$9.80

0.0×

Normal range

90471Normal range

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

130 claims · 0.0%

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

0.0× median

36415Collection of venous blood by venipunctureSee all providers →

3,403 claims

$0.00

$1.57

—

Normal range

36415Normal range

Collection of venous blood by venipuncture

3,403 claims · 0.0%

Your Cost: $0.00/claim|Median: $1.57

83051 See all providers →

142 claims

$0.00

$2.37

—

Normal range

83051Normal range

142 claims · 0.0%

Your Cost: $0.00/claim|Median: $2.37

J1050Injection, medroxyprogesterone acetate, one milligramSee all providers →

13 claims

$0.00

$41.92

—

Normal range

J1050Normal range

Injection, medroxyprogesterone acetate, one milligram

13 claims · 0.0%

Your Cost: $0.00/claim|Median: $41.92

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