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PIONEER HEALTH GROUP LLC

Family Medicine, Addiction Medicine·LOUISA, KY·NPI: 1235585126Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$20.6M

$20,551,129

Total Claims

871K

Beneficiaries

313K

2.8 claims/patient

Avg Cost/Claim

$24

Monthly Spending Trend

Yearly Spending

2018
$194K
+1469%
2019
$3.0M
+51%
2020
$4.6M
-46%
2021
$2.5M
+37%
2022
$3.4M
+15%
2023
$3.9M
-25%
2024
$2.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 29 distinct procedure codes. The top code (80307 (Drug test, presumptive, by chemistry analyzers)) accounts for 56% of total spending.

80307Normal range

Drug test, presumptive, by chemistry analyzers

$11.5M

299K claims · 55.8%

Your Cost: $38.37/claim|Median: $35.43
1.1× median
99211Normal range

Office/outpatient visit, minimal complexity

$5.1M

386K claims · 24.9%

Your Cost: $13.24/claim|Median: $12.93
1.0× median
99213Normal range

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

$1.3M

47K claims · 6.5%

Your Cost: $28.83/claim|Median: $37.81
0.8× median
99484Top 25%

$763K

32K claims · 3.7%

Your Cost: $24.02/claim|Median: $7.13
3.4× median
99203Normal range

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

$252K

6,725 claims · 1.2%

Your Cost: $37.40/claim|Median: $57.85
0.6× median
87426Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$244K

13K claims · 1.2%

Your Cost: $19.00/claim|Median: $30.04
0.6× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$227K

3,314 claims · 1.1%

Your Cost: $68.64/claim|Median: $108.91
0.6× median
G0480Top 25%

Drug test, definitive, 1-7 drug classes

$211K

2,921 claims · 1.0%

Your Cost: $72.21/claim|Median: $37.56
1.9× median
96156Normal range

$191K

3,849 claims · 0.9%

Your Cost: $49.52/claim|Median: $22.36
2.2× median
99212Normal range

Office/outpatient visit, low complexity

$190K

8,612 claims · 0.9%

Your Cost: $22.03/claim|Median: $25.06
0.9× median
99214Normal range

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

$173K

3,882 claims · 0.8%

Your Cost: $44.65/claim|Median: $53.41
0.8× median
80305Normal range

$104K

13K claims · 0.5%

Your Cost: $7.73/claim|Median: $7.44
1.0× median
86580Normal range

Tuberculosis (TB) skin test

$70K

14K claims · 0.3%

Your Cost: $4.96/claim|Median: $4.46
1.1× median
99204Normal range

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

$62K

985 claims · 0.3%

Your Cost: $62.92/claim|Median: $84.03
0.7× median
81025Normal range

Urine pregnancy test

$58K

13K claims · 0.3%

Your Cost: $4.64/claim|Median: $4.81
1.0× median
98960Normal range

$20K

2,049 claims · 0.1%

Your Cost: $9.62/claim|Median: $12.74
0.8× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$12K

1,372 claims · 0.1%

Your Cost: $8.62/claim|Median: $9.56
0.9× median
G0472Top 25%

$12K

421 claims · 0.1%

Your Cost: $27.66/claim|Median: $14.24
1.9× median
87804Normal range

Influenza virus detection, rapid test

$6K

558 claims · 0.0%

Your Cost: $10.44/claim|Median: $12.59
0.8× median
86703Normal range

$4K

455 claims · 0.0%

Your Cost: $9.88/claim|Median: $10.37
1.0× median
99072Normal range

$4K

13K claims · 0.0%

Your Cost: $0.31/claim|Median: $0.54
0.6× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$3K

80 claims · 0.0%

Your Cost: $33.62/claim|Median: $39.70
0.8× median
90471Normal range

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

$3K

738 claims · 0.0%

Your Cost: $3.52/claim|Median: $9.80
0.4× median
90791Normal range

Psychiatric diagnostic evaluation

$2K

28 claims · 0.0%

Your Cost: $89.09/claim|Median: $99.21
0.9× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$2K

81 claims · 0.0%

Your Cost: $27.61/claim|Median: $40.11
0.7× median
82075Normal range

Alcohol (ethanol) breath test

$987

47 claims · 0.0%

Your Cost: $21.00/claim|Median: $16.59
1.3× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$767

76 claims · 0.0%

Your Cost: $10.10/claim|Median: $11.48
0.9× median
99215Normal range

Office/outpatient visit, high complexity

$752

20 claims · 0.0%

Your Cost: $37.60/claim|Median: $74.09
0.5× median
888888Normal range

$0

5,700 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.02

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