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TWELVESTONE MEDICAL, INC.

Pharmacy, Home Infusion Therapy Pharmacy·MURFREESBORO, TN·NPI: 1154418218Share
Active Billing Period:2018-01→2024-06(77 months)

Total Paid

$52.6M

$52,617,864

Total Claims

484K

Beneficiaries

165K

2.9 claims/patient

Avg Cost/Claim

$109

Monthly Spending Trend

Yearly Spending

2018
$4.8M
+100%
2019
$9.7M
+19%
2020
$11.5M
-20%
2021
$9.3M
+5%
2022
$9.7M
-23%
2023
$7.4M
-97%
2024
$218K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (J1726) accounts for 39% of total spending.

J1726Normal range

$20.6M

28K claims · 39.2%

Your Cost: $744.36/claim|Median: $789.74
0.9× median
B4161Normal range

Enteral formula, semisolid, 100 calories = 1 unit

$9.1M

30K claims · 17.4%

Your Cost: $307.67/claim|Median: $465.86
0.7× median
B4035Normal range

Enteral feeding supply kit, pump fed, per day

$7.4M

107K claims · 14.2%

Your Cost: $69.67/claim|Median: $117.24
0.6× median
B4160Normal range

Enteral formula, per 100 calories

$3.9M

42K claims · 7.3%

Your Cost: $92.56/claim|Median: $157.30
0.6× median
B4149Normal range

Enteral formula, manufactured blenderized, per 100 calories

$3.1M

19K claims · 5.9%

Your Cost: $159.21/claim|Median: $300.16
0.5× median
J1745Normal range

Injection, infliximab, excludes biosimilar, 10 mg

$1.5M

619 claims · 2.9%

Your Cost: $2,429.27/claim|Median: $1,587.53
1.5× median
B4034Normal range

$1.0M

43K claims · 2.0%

Your Cost: $24.01/claim|Median: $46.28
0.5× median
B4152Normal range

Enteral formula, calorically dense, per 100 calories

$798K

19K claims · 1.5%

Your Cost: $41.37/claim|Median: $92.20
0.4× median
B4153Normal range

$738K

5,779 claims · 1.4%

Your Cost: $127.65/claim|Median: $410.73
0.3× median
S9342Normal range

Home infusion therapy, continuous or intermittent, per diem

$725K

67K claims · 1.4%

Your Cost: $10.78/claim|Median: $176.25
0.1× median
B9002Normal range

$513K

8,897 claims · 1.0%

Your Cost: $57.62/claim|Median: $54.41
1.1× median
B4150Normal range

Enteral formula, nutritionally complete with fiber, per 100 calories

$494K

13K claims · 0.9%

Your Cost: $38.91/claim|Median: $89.79
0.4× median
S9500Normal range

$314K

7,514 claims · 0.6%

Your Cost: $41.85/claim|Median: $144.40
0.3× median
B4158Normal range

$314K

2,305 claims · 0.6%

Your Cost: $136.19/claim|Median: $145.71
0.9× median
B4088Normal range

$311K

11K claims · 0.6%

Your Cost: $27.23/claim|Median: $73.20
0.4× median
B4155Normal range

$272K

13K claims · 0.5%

Your Cost: $21.68/claim|Median: $46.72
0.5× median
B4154Normal range

$257K

3,947 claims · 0.5%

Your Cost: $65.04/claim|Median: $132.96
0.5× median
J0585Top 25%

Injection, onabotulinumtoxinA, 1 unit

$163K

175 claims · 0.3%

Your Cost: $930.04/claim|Median: $470.36
2.0× median
B4103Normal range

$140K

3,177 claims · 0.3%

Your Cost: $44.19/claim|Median: $82.54
0.5× median
S9343Normal range

$114K

27K claims · 0.2%

Your Cost: $4.23/claim|Median: $99.47
0.0× median
B4162Normal range

$94K

430 claims · 0.2%

Your Cost: $219.61/claim|Median: $412.82
0.5× median
S9502Normal range

$91K

1,791 claims · 0.2%

Your Cost: $50.60/claim|Median: $165.71
0.3× median
S9501Normal range

$75K

2,000 claims · 0.1%

Your Cost: $37.40/claim|Median: $160.52
0.2× median
S9379Normal range

$71K

2,057 claims · 0.1%

Your Cost: $34.74/claim|Median: $70.89
0.5× median
E0570Top 25%

Nebulizer, with compressor

$62K

1,033 claims · 0.1%

Your Cost: $60.38/claim|Median: $16.16
3.7× median
E0776Normal range

$52K

5,842 claims · 0.1%

Your Cost: $8.88/claim|Median: $8.13
1.1× median
T4541Normal range

Pediatric-sized disposable incontinence product, large

$39K

1,392 claims · 0.1%

Your Cost: $27.95/claim|Median: $41.28
0.7× median
S5501Normal range

$34K

5,105 claims · 0.1%

Your Cost: $6.69/claim|Median: $43.74
0.2× median
E0601Normal range

Continuous positive airway pressure (CPAP) device

$29K

840 claims · 0.1%

Your Cost: $34.90/claim|Median: $35.30
1.0× median
B4185Normal range

$24K

227 claims · 0.0%

Your Cost: $105.07/claim|Median: $134.70
0.8× median
B4081Normal range

$20K

1,382 claims · 0.0%

Your Cost: $14.42/claim|Median: $36.64
0.4× median
S5502Normal range

$16K

2,098 claims · 0.0%

Your Cost: $7.50/claim|Median: $25.28
0.3× median
E1390Normal range

Oxygen concentrator, single delivery port

$15K

239 claims · 0.0%

Your Cost: $61.29/claim|Median: $45.11
1.4× median
B4100Normal range

$14K

762 claims · 0.0%

Your Cost: $18.28/claim|Median: $67.58
0.3× median
A7030Normal range

Full face mask for CPAP device

$13K

292 claims · 0.0%

Your Cost: $43.63/claim|Median: $56.36
0.8× median
A7034Normal range

$10K

318 claims · 0.0%

Your Cost: $31.11/claim|Median: $35.90
0.9× median
E0562Normal range

Humidifier, heated, used with positive airway pressure device

$9K

900 claims · 0.0%

Your Cost: $10.10/claim|Median: $18.68
0.5× median
J3370Top 5%

$9K

98 claims · 0.0%

Your Cost: $87.09/claim|Median: $2.40
36.3× median
A7005Normal range

$7K

637 claims · 0.0%

Your Cost: $11.41/claim|Median: $12.44
0.9× median
A4604Normal range

$5K

256 claims · 0.0%

Your Cost: $19.90/claim|Median: $22.01
0.9× median
E0118Normal range

$5K

252 claims · 0.0%

Your Cost: $20.22/claim|Median: $40.16
0.5× median
A7035Normal range

$3K

316 claims · 0.0%

Your Cost: $10.58/claim|Median: $13.01
0.8× median
A4606Normal range

$3K

283 claims · 0.0%

Your Cost: $11.80/claim|Median: $50.63
0.2× median
A7037Normal range

$3K

355 claims · 0.0%

Your Cost: $9.20/claim|Median: $10.56
0.9× median
T4530Normal range

$3K

49 claims · 0.0%

Your Cost: $58.98/claim|Median: $83.90
0.7× median
T4535Normal range

Adult-sized disposable underpads/pads, large

$3K

59 claims · 0.0%

Your Cost: $46.98/claim|Median: $42.03
1.1× median
A7031Normal range

$3K

152 claims · 0.0%

Your Cost: $17.36/claim|Median: $25.17
0.7× median
A7038Normal range

$2K

859 claims · 0.0%

Your Cost: $2.84/claim|Median: $3.53
0.8× median
A4628Top 25%

$2K

86 claims · 0.0%

Your Cost: $19.20/claim|Median: $7.48
2.6× median
E0431Normal range

Portable gaseous oxygen system, rental

$1K

155 claims · 0.0%

Your Cost: $9.64/claim|Median: $10.37
0.9× median

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