Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Provider 1215094354

NPI: 1215094354Share
Active Billing Period:2018-012024-11(69 months)

Total Paid

$11.6M

$11,609,508

Total Claims

155K

Beneficiaries

11K

13.5 claims/patient

Avg Cost/Claim

$75

Monthly Spending Trend

Yearly Spending

2018
$1.6M
+3%
2019
$1.7M
-53%
2020
$773K
+135%
2021
$1.8M
+12%
2022
$2.0M
+1%
2023
$2.1M
-20%
2024
$1.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 13 distinct procedure codes. The top code (T1020 (Personal care services, per diem)) accounts for 38% of total spending.

T1020Normal range

Personal care services, per diem

$4.5M

24K claims · 38.5%

Your Cost: $184.61/claim|Median: $296.27
0.6× median
96159Top 25%

$3.5M

28K claims · 29.9%

Your Cost: $124.91/claim|Median: $20.68
6.0× median
96165Top 25%

Health behavior intervention, family, each additional fifteen minutes

$767K

11K claims · 6.6%

Your Cost: $67.03/claim|Median: $15.54
4.3× median
A0130Normal range

Non-emergency wheelchair van transport

$750K

28K claims · 6.5%

Your Cost: $26.85/claim|Median: $29.37
0.9× median
96152Top 25%

Health behavior intervention, individual

$733K

6,404 claims · 6.3%

Your Cost: $114.53/claim|Median: $20.02
5.7× median
96153Top 5%

Health/behavior intervention, group

$505K

6,564 claims · 4.3%

Your Cost: $76.93/claim|Median: $6.67
11.5× median
96158Normal range

$503K

29K claims · 4.3%

Your Cost: $17.34/claim|Median: $28.43
0.6× median
T1019Normal range

Personal care services, per 15 min

$212K

4,217 claims · 1.8%

Your Cost: $50.39/claim|Median: $82.47
0.6× median
96164Normal range

$147K

13K claims · 1.3%

Your Cost: $11.49/claim|Median: $9.87
1.2× median
T2001Normal range

Non-emergency transportation, patient attendant or aide

$53K

4,728 claims · 0.5%

Your Cost: $11.15/claim|Median: $19.61
0.6× median
A0120Normal range

Non-emergency mini-bus transport

$518

198 claims · 0.0%

Your Cost: $2.62/claim|Median: $16.09
0.2× median
T5999Normal range

Transportation service, not otherwise classified

$408

88 claims · 0.0%

Your Cost: $4.64/claim|Median: $8.13
0.6× median
T1001Normal range

Nursing assessment/evaluation, per visit

$273

16 claims · 0.0%

Your Cost: $17.09/claim|Median: $49.05
0.3× median