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Provider 1265591168

NPI: 1265591168Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$10.3M

$10,349,944

Total Claims

91K

Beneficiaries

29K

3.1 claims/patient

Avg Cost/Claim

$114

Monthly Spending Trend

Yearly Spending

2018
$434K
+219%
2019
$1.4M
+50%
2020
$2.1M
+4%
2021
$2.2M
-12%
2022
$1.9M
-36%
2023
$1.2M
-3%
2024
$1.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 24 distinct procedure codes. The top code (S9123 (Nursing care, in the home, by RN, per 15 minutes)) accounts for 36% of total spending.

S9123Normal range

Nursing care, in the home, by RN, per 15 minutes

$3.7M

35K claims · 36.0%

Your Cost: $106.91/claim|Median: $124.86
0.9× median
S9131Top 25%

Physical therapy, in the home, per diem

$3.6M

32K claims · 35.2%

Your Cost: $113.82/claim|Median: $90.35
1.3× median
T1030Top 10%

Nursing care, in the home, by RN, per diem

$1.5M

9,737 claims · 14.7%

Your Cost: $156.69/claim|Median: $85.62
1.8× median
S9127Top 25%

Social work visit, in the home, per diem

$538K

3,983 claims · 5.2%

Your Cost: $135.15/claim|Median: $98.75
1.4× median
S9129Top 25%

OT, in the home, per diem

$522K

5,119 claims · 5.0%

Your Cost: $102.02/claim|Median: $76.61
1.3× median
S9122Normal range

Home health aide or certified nurse, per hour

$317K

3,979 claims · 3.1%

Your Cost: $79.57/claim|Median: $116.67
0.7× median
99214Top 10%

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

$30K

280 claims · 0.3%

Your Cost: $106.07/claim|Median: $53.41
2.0× median
99213Top 25%

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

$24K

433 claims · 0.2%

Your Cost: $55.91/claim|Median: $37.81
1.5× median
99285Top 10%

Emergency dept visit, high/urgent complexity

$3K

14 claims · 0.0%

Your Cost: $226.81/claim|Median: $85.65
2.6× median
99284Top 25%

Emergency dept visit, high complexity

$3K

28 claims · 0.0%

Your Cost: $109.24/claim|Median: $69.51
1.6× median
99203Top 10%

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

$3K

26 claims · 0.0%

Your Cost: $108.38/claim|Median: $57.85
1.9× median
T1001Top 10%

Nursing assessment/evaluation, per visit

$3K

17 claims · 0.0%

Your Cost: $158.82/claim|Median: $49.05
3.2× median
99215Top 5%

Office/outpatient visit, high complexity

$2K

12 claims · 0.0%

Your Cost: $174.64/claim|Median: $74.09
2.4× median
99283Normal range

Emergency dept visit, moderate complexity

$2K

30 claims · 0.0%

Your Cost: $57.94/claim|Median: $42.48
1.4× median
88305Top 10%

Surgical pathology, gross and microscopic examination

$2K

17 claims · 0.0%

Your Cost: $91.62/claim|Median: $35.80
2.6× median
71046Normal range

Chest X-ray, 2 views

$1K

78 claims · 0.0%

Your Cost: $13.73/claim|Median: $8.92
1.5× median
88112Top 5%

$880

16 claims · 0.0%

Your Cost: $55.02/claim|Median: $19.79
2.8× median
G0151Normal range

Physical therapy services, home health, per visit

$855

65 claims · 0.0%

Your Cost: $13.15/claim|Median: $67.94
0.2× median
93010Top 10%

Electrocardiogram, interpretation and report only

$747

70 claims · 0.0%

Your Cost: $10.66/claim|Median: $5.60
1.9× median
99212Top 25%

Office/outpatient visit, low complexity

$705

13 claims · 0.0%

Your Cost: $54.20/claim|Median: $25.06
2.2× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$132

12 claims · 0.0%

Your Cost: $11.03/claim|Median: $9.56
1.2× median
Q5001Normal range

Injection, filgrastim-sndz, biosimilar, 1 mcg

$0

40 claims · 0.0%

Your Cost: $0.01/claim|Median: $23.43
0.0× median
1BHK1

$0

13 claims · 0.0%

1CHK1

$0

286 claims · 0.0%

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