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Provider 1316112378

NPI: 1316112378Share
Active Billing Period:2021-02→2024-12(47 months)

Total Paid

$11.3M

$11,291,294

Total Claims

70K

Beneficiaries

6,429

10.9 claims/patient

Avg Cost/Claim

$161

Monthly Spending Trend

Yearly Spending

2021
$1.5M
+93%
2022
$2.9M
+22%
2023
$3.5M
-6%
2024
$3.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 16 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 55% of total spending.

H2016Normal range

Comprehensive community support services, per 15 min

$6.2M

11K claims · 54.7%

Your Cost: $542.00/claim|Median: $321.53
1.7× median
T2016Normal range

Habilitation, residential, waiver; per diem

$1.3M

9,423 claims · 11.2%

Your Cost: $133.80/claim|Median: $331.94
0.4× median
M0123Top 1%

$836K

11K claims · 7.4%

Your Cost: $76.14/claim|Median: $76.14
1.0× median
M0125Top 1%

$771K

8,201 claims · 6.8%

Your Cost: $94.07/claim|Median: $94.07
1.0× median
H2014Normal range

Skills training & development, per 15 min

$756K

15K claims · 6.7%

Your Cost: $50.67/claim|Median: $83.88
0.6× median
S5150Top 25%

Unskilled respite care, per 15 min

$467K

3,118 claims · 4.1%

Your Cost: $149.83/claim|Median: $84.46
1.8× median
T2020Normal range

Day habilitation, waiver; per diem

$311K

2,364 claims · 2.8%

Your Cost: $131.49/claim|Median: $87.34
1.5× median
M0360Top 10%

$278K

2,038 claims · 2.5%

Your Cost: $136.61/claim|Median: $102.43
1.3× median
M0240Normal range

$137K

875 claims · 1.2%

Your Cost: $156.46/claim|Median: $141.71
1.1× median
M0116Normal range

$133K

4,186 claims · 1.2%

Your Cost: $31.73/claim|Median: $32.07
1.0× median
M0118Normal range

$76K

1,969 claims · 0.7%

Your Cost: $38.67/claim|Median: $38.00
1.0× median
T1002Top 25%

RN services, per 15 minutes

$36K

331 claims · 0.3%

Your Cost: $109.93/claim|Median: $37.42
2.9× median
D0120Top 1%

Periodic oral evaluation, established patient

$32K

67 claims · 0.3%

Your Cost: $481.46/claim|Median: $24.34
19.8× median
H2019Top 25%

Therapeutic behavioral services, per 15 min

$16K

112 claims · 0.1%

Your Cost: $138.47/claim|Median: $84.12
1.6× median
M0315Top 25%

$3K

65 claims · 0.0%

Your Cost: $44.57/claim|Median: $29.80
1.5× median
T1003Normal range

LPN/LVN services, per 15 minutes

$490

24 claims · 0.0%

Your Cost: $20.42/claim|Median: $24.24
0.8× median
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