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Provider 1164700365

NPI: 1164700365Share
Active Billing Period:2021-02→2024-12(47 months)

Total Paid

$11.4M

$11,429,606

Total Claims

158K

Beneficiaries

8,140

19.4 claims/patient

Avg Cost/Claim

$72

Monthly Spending Trend

Yearly Spending

2021
$1.5M
+99%
2022
$3.0M
+13%
2023
$3.3M
+9%
2024
$3.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 17 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 50% of total spending.

H2016Normal range

Comprehensive community support services, per 15 min

$5.7M

63K claims · 50.1%

Your Cost: $90.46/claim|Median: $321.53
0.3× median
T2016Normal range

Habilitation, residential, waiver; per diem

$1.5M

19K claims · 12.8%

Your Cost: $78.20/claim|Median: $331.94
0.2× median
H2014Normal range

Skills training & development, per 15 min

$1.0M

23K claims · 8.9%

Your Cost: $44.68/claim|Median: $83.88
0.5× median
M0122Top 1%

$589K

8,123 claims · 5.2%

Your Cost: $72.56/claim|Median: $72.56
1.0× median
S5150Normal range

Unskilled respite care, per 15 min

$563K

6,047 claims · 4.9%

Your Cost: $93.11/claim|Median: $84.46
1.1× median
M0360Normal range

$553K

6,939 claims · 4.8%

Your Cost: $79.66/claim|Median: $102.43
0.8× median
M0123Top 1%

$526K

6,910 claims · 4.6%

Your Cost: $76.14/claim|Median: $76.14
1.0× median
T2020Normal range

Day habilitation, waiver; per diem

$364K

9,583 claims · 3.2%

Your Cost: $38.03/claim|Median: $87.34
0.4× median
M0240Normal range

$220K

2,162 claims · 1.9%

Your Cost: $101.95/claim|Median: $141.71
0.7× median
M0116Normal range

$134K

4,192 claims · 1.2%

Your Cost: $31.89/claim|Median: $32.07
1.0× median
M0115Normal range

$131K

4,508 claims · 1.1%

Your Cost: $28.99/claim|Median: $29.58
1.0× median
T1002Normal range

RN services, per 15 minutes

$49K

864 claims · 0.4%

Your Cost: $57.12/claim|Median: $37.42
1.5× median
D0120Top 1%

Periodic oral evaluation, established patient

$34K

100 claims · 0.3%

Your Cost: $342.75/claim|Median: $24.34
14.1× median
T1003Normal range

LPN/LVN services, per 15 minutes

$22K

2,499 claims · 0.2%

Your Cost: $8.70/claim|Median: $24.24
0.4× median
M0299Normal range

$19K

446 claims · 0.2%

Your Cost: $42.97/claim|Median: $34.98
1.2× median
M0298Normal range

$12K

891 claims · 0.1%

Your Cost: $13.85/claim|Median: $13.85
1.0× median
M0315Normal range

$406

14 claims · 0.0%

Your Cost: $29.02/claim|Median: $29.80
1.0× median
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