Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Spero Health of Kentucky LLC

Family Medicine Addiction Medicine·Danville, KY·NPI: 1982102109SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Billing Swing

Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Risk Assessment

Bills $433.68 per claim for H0047 (Alcohol and/or drug abuse, not otherwise specified) — 5.3× the national median of $81.37.

Bills $359.67 per claim for G2087 — 7.5× the national median of $48.10.

Billing above the 90th percentile for 2 procedure codes simultaneously.

This is a statistical summary, not an accusation. See our methodology.

Active Billing Period:2018-022024-12(83 months)

Total Paid

$154.2M

$154,247,261

Total Claims

2.6M

Beneficiaries

1.7M

1.5 claims/patient

Avg Cost/Claim

$59

#694 of 618K providers by total spending(top 0.1%)

🔍 Analysis

Provider Overview

Spero Health of Kentucky LLC is a Family Medicine Addiction Medicine provider based in Danville, KY. From the 2018–2024 period, this provider received $154.2M in Medicaid payments across 2.6M claims.

Why This Matters

This provider received $154.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 19,280 Medicaid beneficiaries for a full year at average per-enrollee costs.

323% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$5.2M
+300%
2019
$20.8M
+14%
2020
$23.6M
+10%
2021
$25.9M
+14%
2022
$29.7M
-9%
2023
$27.1M
-19%
2024
$21.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 29 distinct procedure codes. The top code (80307 (Drug test, presumptive, by chemistry analyzers)) accounts for 22% of total spending.

80307Normal range

Drug test, presumptive, by chemistry analyzers

$34.1M

728K claims · 22.1%

Your Cost: $46.78/claim|Median: $35.43
1.3× median
99213Normal range

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

$20.1M

427K claims · 13.1%

Your Cost: $47.20/claim|Median: $37.81
1.3× median
G0482Top 25%

Drug test, definitive, 15-21 drug classes

$17.9M

132K claims · 11.6%

Your Cost: $135.62/claim|Median: $75.26
1.8× median
G0480Top 25%

Drug test, definitive, 1-7 drug classes

$17.5M

219K claims · 11.3%

Your Cost: $79.92/claim|Median: $37.56
2.1× median
T2023Normal range

Community transition, waiver; per service

$17.2M

59K claims · 11.2%

Your Cost: $292.28/claim|Median: $300.13
1.0× median
G0483Top 25%

Drug test, definitive, 22+ drug classes

$8.1M

52K claims · 5.3%

Your Cost: $156.58/claim|Median: $90.89
1.7× median
99214Normal range

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

$7.6M

129K claims · 5.0%

Your Cost: $59.21/claim|Median: $53.41
1.1× median
T1007Normal range

Alcohol/drug services, treatment plan review

$7.0M

113K claims · 4.5%

Your Cost: $61.99/claim|Median: $64.10
1.0× median
90853Normal range

Group psychotherapy

$5.9M

482K claims · 3.9%

Your Cost: $12.33/claim|Median: $25.02
0.5× median
H0047Top 10%

Alcohol and/or drug abuse, not otherwise specified

$5.4M

13K claims · 3.5%

Your Cost: $433.68/claim|Median: $81.37
5.3× median
90832Normal range

Psychotherapy, 30 minutes

$5.3M

153K claims · 3.4%

Your Cost: $34.51/claim|Median: $41.28
0.8× median
G0481Normal range

Drug test, definitive, 8-14 drug classes

$3.6M

40K claims · 2.3%

Your Cost: $89.94/claim|Median: $64.72
1.4× median
G2087Top 10%

$1.7M

5K claims · 1.1%

Your Cost: $359.67/claim|Median: $48.10
7.5× median
90791Normal range

Psychiatric diagnostic evaluation

$833K

11K claims · 0.5%

Your Cost: $73.28/claim|Median: $99.21
0.7× median
99212Normal range

Office/outpatient visit, low complexity

$559K

18K claims · 0.4%

Your Cost: $30.69/claim|Median: $25.06
1.2× median
99215Normal range

Office/outpatient visit, high complexity

$553K

6K claims · 0.4%

Your Cost: $92.44/claim|Median: $74.09
1.3× median
H0038Normal range

Self-help/peer services, per 15 minutes

$308K

20K claims · 0.2%

Your Cost: $15.07/claim|Median: $55.04
0.3× median
90837Normal range

Psychotherapy, 60 minutes

$226K

3K claims · 0.1%

Your Cost: $69.29/claim|Median: $85.66
0.8× median
99203Normal range

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

$77K

1K claims · 0.0%

Your Cost: $52.86/claim|Median: $57.85
0.9× median
99204Normal range

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

$58K

669 claims · 0.0%

Your Cost: $86.48/claim|Median: $84.03
1.0× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$38K

435 claims · 0.0%

Your Cost: $86.54/claim|Median: $108.91
0.8× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$33K

308 claims · 0.0%

Your Cost: $106.98/claim|Median: $111.09
1.0× median
90834Normal range

Psychotherapy, 45 minutes

$31K

649 claims · 0.0%

Your Cost: $48.32/claim|Median: $63.65
0.8× median
H0015Normal range

Alcohol and/or drug abuse, intensive outpatient, per hour

$24K

345 claims · 0.0%

Your Cost: $70.35/claim|Median: $129.75
0.5× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$19K

485 claims · 0.0%

Your Cost: $39.04/claim|Median: $40.11
1.0× median
99211Normal range

Office/outpatient visit, minimal complexity

$3K

214 claims · 0.0%

Your Cost: $15.59/claim|Median: $12.93
1.2× median
H0001Normal range

Alcohol and/or drug assessment

$2K

43 claims · 0.0%

Your Cost: $36.08/claim|Median: $94.22
0.4× median
99201Normal range

Office/outpatient visit, new patient, straightforward

$1K

56 claims · 0.0%

Your Cost: $21.82/claim|Median: $27.38
0.8× median
99406Top 25%

$129

13 claims · 0.0%

Your Cost: $9.95/claim|Median: $6.53
1.5× median