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Provider 1578698395

NPI: 1578698395Share
Active Billing Period:2021-01→2024-12(48 months)

Total Paid

$7.9M

$7,902,423

Total Claims

120K

Beneficiaries

9,041

13.3 claims/patient

Avg Cost/Claim

$66

Monthly Spending Trend

Yearly Spending

2021
$1.1M
+98%
2022
$2.2M
-0%
2023
$2.2M
+4%
2024
$2.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 19 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 61% of total spending.

H2016Normal range

Comprehensive community support services, per 15 min

$4.8M

25K claims · 61.2%

Your Cost: $192.80/claim|Median: $321.53
0.6× median
H2014Normal range

Skills training & development, per 15 min

$784K

38K claims · 9.9%

Your Cost: $20.78/claim|Median: $83.88
0.2× median
M0166Normal range

$731K

5,125 claims · 9.2%

Your Cost: $142.56/claim|Median: $151.35
0.9× median
M0123Top 1%

$392K

5,153 claims · 5.0%

Your Cost: $76.14/claim|Median: $76.14
1.0× median
T2020Normal range

Day habilitation, waiver; per diem

$369K

12K claims · 4.7%

Your Cost: $30.20/claim|Median: $87.34
0.3× median
M0115Normal range

$220K

7,820 claims · 2.8%

Your Cost: $28.08/claim|Median: $29.58
0.9× median
M0116Normal range

$181K

5,888 claims · 2.3%

Your Cost: $30.79/claim|Median: $32.07
1.0× median
M0201Normal range

$114K

4,122 claims · 1.4%

Your Cost: $27.74/claim|Median: $18.33
1.5× median
D0120Top 1%

Periodic oral evaluation, established patient

$102K

355 claims · 1.3%

Your Cost: $287.64/claim|Median: $24.34
11.8× median
T1003Normal range

LPN/LVN services, per 15 minutes

$42K

5,004 claims · 0.5%

Your Cost: $8.40/claim|Median: $24.24
0.3× median
M0372Normal range

$30K

3,387 claims · 0.4%

Your Cost: $8.81/claim|Median: $13.55
0.7× median
M0419Normal range

$28K

2,812 claims · 0.4%

Your Cost: $9.89/claim|Median: $12.20
0.8× median
T1002Normal range

RN services, per 15 minutes

$24K

1,162 claims · 0.3%

Your Cost: $20.31/claim|Median: $37.42
0.5× median
M0298Normal range

$18K

2,045 claims · 0.2%

Your Cost: $8.86/claim|Median: $13.85
0.6× median
T2016Normal range

Habilitation, residential, waiver; per diem

$18K

1,742 claims · 0.2%

Your Cost: $10.14/claim|Median: $331.94
0.0× median
M0113Normal range

$4K

14 claims · 0.0%

Your Cost: $256.79/claim|Median: $397.30
0.6× median
M0299Normal range

$4K

154 claims · 0.0%

Your Cost: $22.94/claim|Median: $34.98
0.7× median
M0315Normal range

$3K

134 claims · 0.0%

Your Cost: $21.08/claim|Median: $29.80
0.7× median
M0360Normal range

$586

47 claims · 0.0%

Your Cost: $12.47/claim|Median: $102.43
0.1× median
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