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Provider 1538208566

NPI: 1538208566Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$14.1M

$14,127,710

Total Claims

1.2M

Beneficiaries

100K

11.7 claims/patient

Avg Cost/Claim

$12

Monthly Spending Trend

Yearly Spending

2018
$478K
+157%
2019
$1.2M
+56%
2020
$1.9M
+21%
2021
$2.3M
+3%
2022
$2.4M
+17%
2023
$2.8M
+7%
2024
$3.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 20 distinct procedure codes. The top code (G9012 (Other specified case management service, per 15 minutes)) accounts for 29% of total spending.

G9012Normal range

Other specified case management service, per 15 minutes

$4.0M

18K claims · 28.6%

Your Cost: $224.94/claim|Median: $137.85
1.6× median
H0020Normal range

Alcohol/drug services; methadone administration

$3.8M

501K claims · 26.9%

Your Cost: $7.57/claim|Median: $18.95
0.4× median
S0109Normal range

$1.8M

380K claims · 12.7%

Your Cost: $4.71/claim|Median: $4.67
1.0× median
H0004Normal range

Behavioral health counseling & therapy, per 15 min

$1.8M

50K claims · 12.6%

Your Cost: $35.35/claim|Median: $74.63
0.5× median
J0574Normal range

$1.0M

79K claims · 7.3%

Your Cost: $13.18/claim|Median: $15.76
0.8× median
J0572Normal range

$632K

76K claims · 4.5%

Your Cost: $8.33/claim|Median: $8.49
1.0× median
80305Top 25%

$328K

30K claims · 2.3%

Your Cost: $11.11/claim|Median: $7.44
1.5× median
J0571Normal range

$238K

22K claims · 1.7%

Your Cost: $10.96/claim|Median: $7.96
1.4× median
H0005Normal range

Alcohol and/or drug services, group counseling

$119K

6,201 claims · 0.8%

Your Cost: $19.23/claim|Median: $47.35
0.4× median
H0010Normal range

Alcohol and/or drug services, sub-acute detoxification, per diem

$114K

657 claims · 0.8%

Your Cost: $173.36/claim|Median: $369.55
0.5× median
H0014Normal range

$104K

826 claims · 0.7%

Your Cost: $126.27/claim|Median: $137.81
0.9× median
99213Normal range

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

$71K

1,641 claims · 0.5%

Your Cost: $43.46/claim|Median: $37.81
1.1× median
99215Normal range

Office/outpatient visit, high complexity

$48K

544 claims · 0.3%

Your Cost: $88.80/claim|Median: $74.09
1.2× median
82075Normal range

Alcohol (ethanol) breath test

$10K

2,344 claims · 0.1%

Your Cost: $4.20/claim|Median: $16.59
0.3× median
J0573Normal range

$8K

826 claims · 0.1%

Your Cost: $9.15/claim|Median: $12.82
0.7× median
J0575Top 25%

$7K

128 claims · 0.0%

Your Cost: $51.65/claim|Median: $14.96
3.5× median
86580Normal range

Tuberculosis (TB) skin test

$6K

1,080 claims · 0.0%

Your Cost: $5.88/claim|Median: $4.46
1.3× median
99214Normal range

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

$4K

69 claims · 0.0%

Your Cost: $56.85/claim|Median: $53.41
1.1× median
81025Top 25%

Urine pregnancy test

$2K

310 claims · 0.0%

Your Cost: $6.81/claim|Median: $4.81
1.4× median
86592Normal range

$17

14 claims · 0.0%

Your Cost: $1.19/claim|Median: $3.35
0.4× median
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