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Provider 1396938270

NPI: 1396938270Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$18.0M

$17,998,034

Total Claims

161K

Beneficiaries

80K

2.0 claims/patient

Avg Cost/Claim

$112

Monthly Spending Trend

Yearly Spending

2018
$1.6M
+17%
2019
$1.9M
-22%
2020
$1.5M
+27%
2021
$1.9M
+59%
2022
$3.0M
+14%
2023
$3.4M
+34%
2024
$4.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 15 distinct procedure codes. The top code (T1016 (Case management, each 15 min)) accounts for 58% of total spending.

T1016Top 25%

Case management, each 15 min

$10.4M

85K claims · 57.8%

Your Cost: $123.03/claim|Median: $49.62
2.5× median
T1017Normal range

Targeted case management, per 15 min

$4.4M

69K claims · 24.6%

Your Cost: $63.86/claim|Median: $69.56
0.9× median
H0041Top 5%

$1.7M

676 claims · 9.3%

Your Cost: $2,470.69/claim|Median: $192.56
12.8× median
S5150Top 10%

Unskilled respite care, per 15 min

$356K

967 claims · 2.0%

Your Cost: $368.25/claim|Median: $84.46
4.4× median
S5165Top 25%

Home modifications, per service

$292K

76 claims · 1.6%

Your Cost: $3,837.60/claim|Median: $2,196.32
1.7× median
T2028Top 25%

Specialized supply, NOS; per unit

$264K

1,236 claims · 1.5%

Your Cost: $213.50/claim|Median: $79.30
2.7× median
A9999Top 25%

$230K

1,425 claims · 1.3%

Your Cost: $161.57/claim|Median: $39.73
4.1× median
E1399Normal range

Durable medical equipment, miscellaneous

$99K

624 claims · 0.6%

Your Cost: $159.33/claim|Median: $104.06
1.5× median
S5115Top 1%

Home modifications, per service

$72K

244 claims · 0.4%

Your Cost: $295.61/claim|Median: $62.72
4.7× median
T1999Normal range

Miscellaneous therapeutic items and supplies

$59K

554 claims · 0.3%

Your Cost: $105.66/claim|Median: $28.63
3.7× median
G0176Normal range

Activity therapy (group), per session

$45K

666 claims · 0.3%

Your Cost: $67.96/claim|Median: $85.09
0.8× median
T2013Normal range

Habilitation, residential, waiver, per hour

$45K

479 claims · 0.3%

Your Cost: $94.06/claim|Median: $158.23
0.6× median
E1902Normal range

$25K

107 claims · 0.1%

Your Cost: $235.28/claim|Median: $398.83
0.6× median
S9445Top 5%

$5K

16 claims · 0.0%

Your Cost: $293.67/claim|Median: $12.72
23.1× median
E0700Normal range

$1K

31 claims · 0.0%

Your Cost: $46.39/claim|Median: $16.00
2.9× median
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