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Provider 1295988186

NPI: 1295988186Share
Active Billing Period:2021-02→2024-12(47 months)

Total Paid

$15.0M

$14,971,205

Total Claims

78K

Beneficiaries

9,457

8.2 claims/patient

Avg Cost/Claim

$193

Monthly Spending Trend

Yearly Spending

2021
$1.9M
+123%
2022
$4.1M
+9%
2023
$4.5M
-1%
2024
$4.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 21 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 66% of total spending.

H2016Normal range

Comprehensive community support services, per 15 min

$9.9M

12K claims · 66.2%

Your Cost: $808.39/claim|Median: $321.53
2.5× median
H2014Normal range

Skills training & development, per 15 min

$1.3M

22K claims · 9.0%

Your Cost: $62.21/claim|Median: $83.88
0.7× median
M0152Top 25%

$1.1M

6,494 claims · 7.6%

Your Cost: $175.89/claim|Median: $174.64
1.0× median
M0150Top 10%

$1.1M

6,716 claims · 7.3%

Your Cost: $162.22/claim|Median: $161.06
1.0× median
T2020Normal range

Day habilitation, waiver; per diem

$538K

4,949 claims · 3.6%

Your Cost: $108.63/claim|Median: $87.34
1.2× median
M0118Normal range

$316K

8,990 claims · 2.1%

Your Cost: $35.10/claim|Median: $38.00
0.9× median
M0116Normal range

$246K

8,069 claims · 1.6%

Your Cost: $30.50/claim|Median: $32.07
1.0× median
T1002Normal range

RN services, per 15 minutes

$183K

3,942 claims · 1.2%

Your Cost: $46.43/claim|Median: $37.42
1.2× median
D0120Top 1%

Periodic oral evaluation, established patient

$63K

79 claims · 0.4%

Your Cost: $796.19/claim|Median: $24.34
32.7× median
M0299Normal range

$27K

729 claims · 0.2%

Your Cost: $36.48/claim|Median: $34.98
1.0× median
T1003Normal range

LPN/LVN services, per 15 minutes

$24K

1,595 claims · 0.2%

Your Cost: $14.80/claim|Median: $24.24
0.6× median
H2019Normal range

Therapeutic behavioral services, per 15 min

$17K

247 claims · 0.1%

Your Cost: $67.22/claim|Median: $84.12
0.8× median
M0298Normal range

$15K

885 claims · 0.1%

Your Cost: $17.48/claim|Median: $13.85
1.3× median
M0113Top 5%

$15K

17 claims · 0.1%

Your Cost: $869.24/claim|Median: $397.30
2.2× median
M0101Normal range

$12K

260 claims · 0.1%

Your Cost: $47.40/claim|Median: $65.66
0.7× median
M0133Normal range

$9K

100 claims · 0.1%

Your Cost: $85.89/claim|Median: $84.70
1.0× median
T2025Normal range

Waiver services, NOS; per 15 min

$6K

94 claims · 0.0%

Your Cost: $63.14/claim|Median: $124.39
0.5× median
M0315Top 5%

$5K

77 claims · 0.0%

Your Cost: $58.96/claim|Median: $29.80
2.0× median
A9153Top 25%

$3K

33 claims · 0.0%

Your Cost: $83.75/claim|Median: $45.63
1.8× median
M0248Normal range

$3K

458 claims · 0.0%

Your Cost: $5.75/claim|Median: $5.31
1.1× median
S5199Normal range

Personal care item, NOS, each

$2K

46 claims · 0.0%

Your Cost: $35.87/claim|Median: $10.82
3.3× median
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