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CONFEDERATED TRIBES OF THE GRAND RONDE COMMUNITY OF OREGON

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy·GRAND RONDE, OR·NPI: 1174666358Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$18.6M

$18,571,106

Total Claims

205K

Beneficiaries

51K

4.0 claims/patient

Avg Cost/Claim

$91

Monthly Spending Trend

Yearly Spending

2018
$1.1M
+19%
2019
$1.4M
-18%
2020
$1.1M
+18%
2021
$1.3M
+35%
2022
$1.8M
+101%
2023
$3.5M
+137%
2024
$8.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 37 distinct procedure codes. The top code (H0020 (Alcohol/drug services; methadone administration)) accounts for 40% of total spending.

H0020Normal range

Alcohol/drug services; methadone administration

$7.5M

151K claims · 40.2%

Your Cost: $49.53/claim|Median: $18.95
2.6× median
99214Top 1%

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

$2.5M

9,463 claims · 13.5%

Your Cost: $264.12/claim|Median: $53.41
4.9× median
99213Top 1%

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

$2.0M

6,882 claims · 10.7%

Your Cost: $289.58/claim|Median: $37.81
7.7× median
H0004Top 10%

Behavioral health counseling & therapy, per 15 min

$1.8M

11K claims · 9.6%

Your Cost: $156.08/claim|Median: $74.63
2.1× median
90837Top 1%

Psychotherapy, 60 minutes

$843K

1,709 claims · 4.5%

Your Cost: $493.45/claim|Median: $85.66
5.8× median
D0140Top 1%

Limited oral evaluation, problem focused

$660K

1,349 claims · 3.6%

Your Cost: $488.91/claim|Median: $27.07
18.1× median
D1110Top 1%

Prophylaxis, adult cleaning

$593K

1,193 claims · 3.2%

Your Cost: $497.36/claim|Median: $43.38
11.5× median
D1120Top 1%

Prophylaxis, adult

$575K

1,198 claims · 3.1%

Your Cost: $479.81/claim|Median: $33.86
14.2× median
H0005Top 25%

Alcohol and/or drug services, group counseling

$486K

6,878 claims · 2.6%

Your Cost: $70.61/claim|Median: $47.35
1.5× median
D0120Top 1%

Periodic oral evaluation, established patient

$310K

552 claims · 1.7%

Your Cost: $561.93/claim|Median: $24.34
23.1× median
92014Top 1%

Ophthalmological exam, comprehensive, established patient

$195K

472 claims · 1.0%

Your Cost: $412.82/claim|Median: $47.08
8.8× median
99211Top 1%

Office/outpatient visit, minimal complexity

$194K

406 claims · 1.0%

Your Cost: $477.49/claim|Median: $12.93
36.9× median
H0038Normal range

Self-help/peer services, per 15 minutes

$180K

2,407 claims · 1.0%

Your Cost: $74.84/claim|Median: $55.04
1.4× median
D0150Top 1%

Comprehensive oral evaluation, new or established patient

$166K

330 claims · 0.9%

Your Cost: $502.08/claim|Median: $32.07
15.7× median
99204Top 10%

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

$91K

627 claims · 0.5%

Your Cost: $145.29/claim|Median: $84.03
1.7× median
0012ATop 5%

COVID-19 vaccine admin, Moderna, 2nd dose

$80K

522 claims · 0.4%

Your Cost: $153.78/claim|Median: $33.85
4.5× median
J0575Normal range

$78K

4,186 claims · 0.4%

Your Cost: $18.61/claim|Median: $14.96
1.2× median
0011ATop 5%

COVID-19 vaccine admin, Moderna, 1st dose

$77K

527 claims · 0.4%

Your Cost: $145.43/claim|Median: $25.93
5.6× median
H0001Top 25%

Alcohol and/or drug assessment

$74K

445 claims · 0.4%

Your Cost: $166.87/claim|Median: $94.22
1.8× median
99215Top 5%

Office/outpatient visit, high complexity

$49K

143 claims · 0.3%

Your Cost: $345.15/claim|Median: $74.09
4.7× median
92004Top 1%

Ophthalmological exam, comprehensive, new patient

$38K

76 claims · 0.2%

Your Cost: $494.33/claim|Median: $59.72
8.3× median
90834Top 1%

Psychotherapy, 45 minutes

$33K

84 claims · 0.2%

Your Cost: $396.30/claim|Median: $63.65
6.2× median
S0215Normal range

Non-invasive prenatal screening, fetal chromosomal abnormalities

$21K

487 claims · 0.1%

Your Cost: $42.76/claim|Median: $21.33
2.0× median
0064ATop 5%

$19K

94 claims · 0.1%

Your Cost: $200.62/claim|Median: $34.17
5.9× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$15K

469 claims · 0.1%

Your Cost: $32.41/claim|Median: $39.70
0.8× median
H0002Normal range

Behavioral health screening

$14K

400 claims · 0.1%

Your Cost: $35.35/claim|Median: $38.77
0.9× median
H0006Normal range

Alcohol and/or drug services, case management

$9K

552 claims · 0.0%

Your Cost: $15.88/claim|Median: $43.10
0.4× median
99212Top 10%

Office/outpatient visit, low complexity

$6K

101 claims · 0.0%

Your Cost: $60.02/claim|Median: $25.06
2.4× median
99393Top 1%

Preventive medicine, established patient, age 5-11

$6K

12 claims · 0.0%

Your Cost: $496.99/claim|Median: $74.82
6.6× median
0134ATop 5%

$2K

13 claims · 0.0%

Your Cost: $174.04/claim|Median: $33.54
5.2× median
90471Top 5%

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$2K

45 claims · 0.0%

Your Cost: $43.25/claim|Median: $9.80
4.4× median
80053Normal range

Comprehensive metabolic panel

$864

156 claims · 0.0%

Your Cost: $5.54/claim|Median: $7.24
0.8× median
90674Normal range

$313

39 claims · 0.0%

Your Cost: $8.02/claim|Median: $15.16
0.5× median
G0008Normal range

$11

19 claims · 0.0%

Your Cost: $0.57/claim|Median: $2.54
0.2× median
83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$7

15 claims · 0.0%

Your Cost: $0.45/claim|Median: $5.50
0.1× median
V2020Normal range

Frames, purchases

$0

12 claims · 0.0%

Your Cost: $0.00/claim|Median: $19.33
D8670Normal range

Periodic orthodontic treatment visit

$0

315 claims · 0.0%

Your Cost: $0.00/claim|Median: $185.01

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