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Provider 1235206327

NPI: 1235206327Share
Active Billing Period:2018-02→2024-10(72 months)

Total Paid

$8.9M

$8,868,187

Total Claims

99K

Beneficiaries

37K

2.7 claims/patient

Avg Cost/Claim

$89

Monthly Spending Trend

Yearly Spending

2018
$5K
+7380%
2019
$349K
+326%
2020
$1.5M
+46%
2021
$2.2M
-23%
2022
$1.7M
+30%
2023
$2.2M
-52%
2024
$1.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (G0396 (Alcohol/substance abuse structured assessment, 15-30 minutes)) accounts for 32% of total spending.

G0396Top 25%

Alcohol/substance abuse structured assessment, 15-30 minutes

$2.8M

26K claims · 31.5%

Your Cost: $108.82/claim|Median: $40.58
2.7× median
H0005Normal range

Alcohol and/or drug services, group counseling

$1.7M

31K claims · 19.4%

Your Cost: $55.75/claim|Median: $47.35
1.2× median
H0038Normal range

Self-help/peer services, per 15 minutes

$883K

11K claims · 10.0%

Your Cost: $79.43/claim|Median: $55.04
1.4× median
G0397Normal range

$751K

5,256 claims · 8.5%

Your Cost: $142.89/claim|Median: $142.31
1.0× median
99215Top 25%

Office/outpatient visit, high complexity

$625K

4,709 claims · 7.0%

Your Cost: $132.66/claim|Median: $74.09
1.8× median
90832Top 10%

Psychotherapy, 30 minutes

$532K

4,546 claims · 6.0%

Your Cost: $117.02/claim|Median: $41.28
2.8× median
90853Top 10%

Group psychotherapy

$281K

4,454 claims · 3.2%

Your Cost: $63.06/claim|Median: $25.02
2.5× median
T1006Normal range

Alcohol/drug services, family/couple counseling

$227K

2,069 claims · 2.6%

Your Cost: $109.65/claim|Median: $109.04
1.0× median
H0001Top 25%

Alcohol and/or drug assessment

$212K

1,364 claims · 2.4%

Your Cost: $155.29/claim|Median: $94.22
1.6× median
99213Top 5%

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

$154K

1,128 claims · 1.7%

Your Cost: $136.61/claim|Median: $37.81
3.6× median
99214Top 5%

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

$104K

848 claims · 1.2%

Your Cost: $123.04/claim|Median: $53.41
2.3× median
H0014Normal range

$100K

751 claims · 1.1%

Your Cost: $132.97/claim|Median: $137.81
1.0× median
90833Top 10%

Psychotherapy, 30 min, add-on to E/M service

$75K

1,060 claims · 0.8%

Your Cost: $70.87/claim|Median: $38.83
1.8× median
90834Top 5%

Psychotherapy, 45 minutes

$55K

344 claims · 0.6%

Your Cost: $160.88/claim|Median: $63.65
2.5× median
H0004Normal range

Behavioral health counseling & therapy, per 15 min

$51K

1,049 claims · 0.6%

Your Cost: $48.72/claim|Median: $74.63
0.7× median
90791Top 10%

Psychiatric diagnostic evaluation

$45K

221 claims · 0.5%

Your Cost: $205.73/claim|Median: $99.21
2.1× median
H0002Top 10%

Behavioral health screening

$43K

250 claims · 0.5%

Your Cost: $172.52/claim|Median: $38.77
4.4× median
99204Top 10%

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

$37K

261 claims · 0.4%

Your Cost: $142.96/claim|Median: $84.03
1.7× median
S9480Normal range

Intensive outpatient psychiatric services, per diem

$34K

340 claims · 0.4%

Your Cost: $99.43/claim|Median: $135.70
0.7× median
99203Top 5%

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

$24K

179 claims · 0.3%

Your Cost: $134.33/claim|Median: $57.85
2.3× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$19K

153 claims · 0.2%

Your Cost: $123.83/claim|Median: $111.09
1.1× median
H0050Normal range

$19K

433 claims · 0.2%

Your Cost: $43.50/claim|Median: $46.71
0.9× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$16K

1,258 claims · 0.2%

Your Cost: $12.90/claim|Median: $9.56
1.3× median
90882Normal range

Environmental intervention

$15K

531 claims · 0.2%

Your Cost: $28.36/claim|Median: $45.05
0.6× median
90836Top 10%

Psychotherapy, 45 min, add-on to E/M

$13K

125 claims · 0.1%

Your Cost: $104.83/claim|Median: $56.18
1.9× median
90792Top 25%

Psychiatric diagnostic evaluation with medical services

$6K

27 claims · 0.1%

Your Cost: $212.60/claim|Median: $108.91
2.0× median
99396Normal range

Preventive medicine, established patient, age 40-64

$6K

62 claims · 0.1%

Your Cost: $89.27/claim|Median: $76.06
1.2× median
99408Top 5%

$5K

94 claims · 0.1%

Your Cost: $53.94/claim|Median: $9.32
5.8× median
99212Top 5%

Office/outpatient visit, low complexity

$5K

34 claims · 0.1%

Your Cost: $138.07/claim|Median: $25.06
5.5× median
90847Top 5%

Family psychotherapy with patient, 50 min

$4K

16 claims · 0.0%

Your Cost: $250.94/claim|Median: $77.33
3.2× median
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