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CLEANSLATE MEDICAL GROUP OF INDIANA LLC

Internal Medicine, Addiction Medicine·ALEXANDRIA, IN·NPI: 1023464294Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$79.2M

$79,205,806

Total Claims

1.4M

Beneficiaries

870K

1.6 claims/patient

Avg Cost/Claim

$57

Monthly Spending Trend

Yearly Spending

2018
$298K
+1574%
2019
$5.0M
+109%
2020
$10.4M
+51%
2021
$15.7M
+15%
2022
$18.1M
-5%
2023
$17.2M
-27%
2024
$12.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 29 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 46% of total spending.

99214Normal range

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

$36.2M

498K claims · 45.7%

Your Cost: $72.76/claim|Median: $53.41
1.4× median
80307Top 25%

Drug test, presumptive, by chemistry analyzers

$22.1M

428K claims · 27.8%

Your Cost: $51.50/claim|Median: $35.43
1.5× median
99213Normal range

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

$14.0M

273K claims · 17.7%

Your Cost: $51.51/claim|Median: $37.81
1.4× median
G0480Normal range

Drug test, definitive, 1-7 drug classes

$4.2M

88K claims · 5.3%

Your Cost: $48.27/claim|Median: $37.56
1.3× median
T1015Normal range

Clinic visit/encounter, all-inclusive

$1.1M

9,213 claims · 1.4%

Your Cost: $119.02/claim|Median: $121.16
1.0× median
90832Normal range

Psychotherapy, 30 minutes

$598K

13K claims · 0.8%

Your Cost: $46.80/claim|Median: $41.28
1.1× median
Q3014Normal range

Telehealth originating site facility fee

$193K

13K claims · 0.2%

Your Cost: $15.31/claim|Median: $15.37
1.0× median
90791Normal range

Psychiatric diagnostic evaluation

$147K

1,482 claims · 0.2%

Your Cost: $99.37/claim|Median: $99.21
1.0× median
81025Normal range

Urine pregnancy test

$147K

33K claims · 0.2%

Your Cost: $4.44/claim|Median: $4.81
0.9× median
99212Normal range

Office/outpatient visit, low complexity

$145K

6,369 claims · 0.2%

Your Cost: $22.84/claim|Median: $25.06
0.9× median
99203Normal range

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

$70K

2,165 claims · 0.1%

Your Cost: $32.32/claim|Median: $57.85
0.6× median
90834Normal range

Psychotherapy, 45 minutes

$59K

944 claims · 0.1%

Your Cost: $62.46/claim|Median: $63.65
1.0× median
87389Normal range

HIV-1 antigen with HIV-1 and HIV-2 antibodies

$50K

3,068 claims · 0.1%

Your Cost: $16.43/claim|Median: $18.03
0.9× median
99204Normal range

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

$47K

803 claims · 0.1%

Your Cost: $58.89/claim|Median: $84.03
0.7× median
86803Normal range

Hepatitis C antibody

$36K

3,551 claims · 0.0%

Your Cost: $10.08/claim|Median: $10.17
1.0× median
99406Normal range

$30K

4,976 claims · 0.0%

Your Cost: $5.93/claim|Median: $6.53
0.9× median
87340Normal range

Hepatitis B surface antigen detection

$25K

3,535 claims · 0.0%

Your Cost: $7.15/claim|Median: $5.52
1.3× median
99484Normal range

$18K

1,280 claims · 0.0%

Your Cost: $14.20/claim|Median: $7.13
2.0× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$7K

241 claims · 0.0%

Your Cost: $31.02/claim|Median: $40.11
0.8× median
99215Normal range

Office/outpatient visit, high complexity

$4K

50 claims · 0.0%

Your Cost: $80.97/claim|Median: $74.09
1.1× median
80076Normal range

Hepatic function panel

$3K

1,130 claims · 0.0%

Your Cost: $2.89/claim|Median: $4.59
0.6× median
90833Normal range

Psychotherapy, 30 min, add-on to E/M service

$2K

38 claims · 0.0%

Your Cost: $45.63/claim|Median: $38.83
1.2× median
90837Normal range

Psychotherapy, 60 minutes

$1K

19 claims · 0.0%

Your Cost: $57.46/claim|Median: $85.66
0.7× median
G2012Normal range

Brief communication technology-based service

$1K

405 claims · 0.0%

Your Cost: $2.56/claim|Median: $8.79
0.3× median
T1016Normal range

Case management, each 15 min

$839

2,246 claims · 0.0%

Your Cost: $0.37/claim|Median: $49.62
0.0× median
90853Normal range

Group psychotherapy

$447

26 claims · 0.0%

Your Cost: $17.19/claim|Median: $25.02
0.7× median
86704Top 25%

$169

14 claims · 0.0%

Your Cost: $12.05/claim|Median: $7.48
1.6× median
86706Top 25%

$130

12 claims · 0.0%

Your Cost: $10.81/claim|Median: $5.39
2.0× median
36415Top 25%

Collection of venous blood by venipuncture

$45

15 claims · 0.0%

Your Cost: $3.00/claim|Median: $1.57
1.9× median

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