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Provider 1043841422

NPI: 1043841422Share
Active Billing Period:2021-08→2024-12(41 months)

Total Paid

$11.9M

$11,943,534

Total Claims

166K

Beneficiaries

25K

6.7 claims/patient

Avg Cost/Claim

$72

Monthly Spending Trend

Yearly Spending

2021
$164K
+1115%
2022
$2.0M
+94%
2023
$3.9M
+54%
2024
$5.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 15 distinct procedure codes. The top code (97155 (Adaptive behavior treatment with protocol modification, per 15 minutes)) accounts for 30% of total spending.

97155Normal range

Adaptive behavior treatment with protocol modification, per 15 minutes

$3.6M

34K claims · 30.1%

Your Cost: $107.15/claim|Median: $146.45
0.7× median
T1017Normal range

Targeted case management, per 15 min

$2.7M

76K claims · 23.0%

Your Cost: $36.33/claim|Median: $69.56
0.5× median
H2014Normal range

Skills training & development, per 15 min

$1.9M

20K claims · 16.1%

Your Cost: $94.89/claim|Median: $83.88
1.1× median
92507Top 25%

Speech/hearing/language treatment

$925K

12K claims · 7.7%

Your Cost: $79.23/claim|Median: $49.45
1.6× median
96112Top 10%

Developmental test administration

$773K

2,235 claims · 6.5%

Your Cost: $345.79/claim|Median: $102.95
3.4× median
H2027Normal range

Psychoeducational service, per 15 minutes

$700K

7,218 claims · 5.9%

Your Cost: $97.04/claim|Median: $82.72
1.2× median
97530Top 25%

Therapeutic activities, each 15 min

$548K

6,980 claims · 4.6%

Your Cost: $78.46/claim|Median: $33.11
2.4× median
97112Top 5%

Therapeutic procedure, neuromuscular reeducation, per 15 minutes

$289K

3,689 claims · 2.4%

Your Cost: $78.33/claim|Median: $20.04
3.9× median
97110Top 10%

Therapeutic exercises, each 15 min

$276K

3,458 claims · 2.3%

Your Cost: $79.73/claim|Median: $24.49
3.3× median
96130Top 25%

Psychological testing evaluation by professional, first hour

$55K

363 claims · 0.5%

Your Cost: $152.89/claim|Median: $79.21
1.9× median
H2019Normal range

Therapeutic behavioral services, per 15 min

$31K

354 claims · 0.3%

Your Cost: $88.42/claim|Median: $84.12
1.1× median
97165Top 5%

OT evaluation, low complexity

$29K

182 claims · 0.2%

Your Cost: $161.19/claim|Median: $46.78
3.4× median
97116Top 5%

Gait training

$27K

342 claims · 0.2%

Your Cost: $78.86/claim|Median: $12.48
6.3× median
97533Normal range

$13K

191 claims · 0.1%

Your Cost: $69.98/claim|Median: $48.71
1.4× median
H2037Normal range

$12K

139 claims · 0.1%

Your Cost: $86.21/claim|Median: $83.80
1.0× median
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