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Provider 1295254159

NPI: 1295254159Share
Active Billing Period:2020-12→2024-12(48 months)

Total Paid

$11.1M

$11,063,193

Total Claims

132K

Beneficiaries

11K

11.6 claims/patient

Avg Cost/Claim

$84

Monthly Spending Trend

Yearly Spending

2020
$9K
+6920%
2021
$664K
+266%
2022
$2.4M
+50%
2023
$3.6M
+19%
2024
$4.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 17 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 71% of total spending.

H2016Normal range

Comprehensive community support services, per 15 min

$7.8M

69K claims · 70.6%

Your Cost: $112.52/claim|Median: $321.53
0.3× median
H2014Normal range

Skills training & development, per 15 min

$1.1M

25K claims · 10.3%

Your Cost: $45.08/claim|Median: $83.88
0.5× median
M0123Top 1%

$539K

7,073 claims · 4.9%

Your Cost: $76.14/claim|Median: $76.14
1.0× median
H2019Top 25%

Therapeutic behavioral services, per 15 min

$357K

1,958 claims · 3.2%

Your Cost: $182.33/claim|Median: $84.12
2.2× median
T2020Normal range

Day habilitation, waiver; per diem

$338K

9,143 claims · 3.1%

Your Cost: $36.96/claim|Median: $87.34
0.4× median
M0133Top 5%

$196K

1,096 claims · 1.8%

Your Cost: $178.73/claim|Median: $84.70
2.1× median
M0116Normal range

$154K

5,269 claims · 1.4%

Your Cost: $29.30/claim|Median: $32.07
0.9× median
T1003Normal range

LPN/LVN services, per 15 minutes

$138K

6,945 claims · 1.2%

Your Cost: $19.81/claim|Median: $24.24
0.8× median
T1002Top 25%

RN services, per 15 minutes

$133K

1,131 claims · 1.2%

Your Cost: $117.35/claim|Median: $37.42
3.1× median
T2025Normal range

Waiver services, NOS; per 15 min

$75K

1,107 claims · 0.7%

Your Cost: $67.90/claim|Median: $124.39
0.5× median
D0120Top 1%

Periodic oral evaluation, established patient

$57K

131 claims · 0.5%

Your Cost: $438.14/claim|Median: $24.34
18.0× median
M0299Top 10%

$47K

446 claims · 0.4%

Your Cost: $104.33/claim|Median: $34.98
3.0× median
M0298Normal range

$44K

2,492 claims · 0.4%

Your Cost: $17.48/claim|Median: $13.85
1.3× median
M0118Normal range

$29K

880 claims · 0.3%

Your Cost: $32.67/claim|Median: $38.00
0.9× median
S5199Top 10%

Personal care item, NOS, each

$2K

25 claims · 0.0%

Your Cost: $93.73/claim|Median: $10.82
8.7× median
M0315Normal range

$2K

67 claims · 0.0%

Your Cost: $31.09/claim|Median: $29.80
1.0× median
M0248Top 25%

$419

31 claims · 0.0%

Your Cost: $13.52/claim|Median: $5.31
2.5× median
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