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Provider 1619196169

NPI: 1619196169Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$7.9M

$7,940,782

Total Claims

83K

Beneficiaries

34K

2.4 claims/patient

Avg Cost/Claim

$96

Monthly Spending Trend

Yearly Spending

2018
$384K
-4%
2019
$370K
-12%
2020
$326K
+312%
2021
$1.3M
+51%
2022
$2.0M
+2%
2023
$2.1M
-32%
2024
$1.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 29 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 24% of total spending.

H2016Top 25%

Comprehensive community support services, per 15 min

$1.9M

1,041 claims · 23.7%

Your Cost: $1,807.72/claim|Median: $321.53
5.6× median
T1017Normal range

Targeted case management, per 15 min

$1.5M

20K claims · 19.1%

Your Cost: $74.85/claim|Median: $69.56
1.1× median
T1027Top 25%

Family training and counseling, per 15 minutes

$1.4M

14K claims · 17.9%

Your Cost: $103.03/claim|Median: $53.00
1.9× median
H2014Normal range

Skills training & development, per 15 min

$1.2M

21K claims · 15.2%

Your Cost: $56.01/claim|Median: $83.88
0.7× median
M0123Top 1%

$467K

6,129 claims · 5.9%

Your Cost: $76.14/claim|Median: $76.14
1.0× median
H2011Normal range

Crisis intervention service, per 15 minutes

$453K

1,586 claims · 5.7%

Your Cost: $285.59/claim|Median: $215.80
1.3× median
92507Top 5%

Speech/hearing/language treatment

$159K

1,057 claims · 2.0%

Your Cost: $150.16/claim|Median: $49.45
3.0× median
T2020Normal range

Day habilitation, waiver; per diem

$137K

2,105 claims · 1.7%

Your Cost: $65.21/claim|Median: $87.34
0.7× median
90791Normal range

Psychiatric diagnostic evaluation

$130K

1,283 claims · 1.6%

Your Cost: $101.65/claim|Median: $99.21
1.0× median
97530Top 5%

Therapeutic activities, each 15 min

$129K

1,214 claims · 1.6%

Your Cost: $106.55/claim|Median: $33.11
3.2× median
M0115Normal range

$82K

2,804 claims · 1.0%

Your Cost: $29.24/claim|Median: $29.58
1.0× median
M0116Top 25%

$73K

2,156 claims · 0.9%

Your Cost: $33.90/claim|Median: $32.07
1.1× median
99214Normal range

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

$60K

1,183 claims · 0.8%

Your Cost: $50.82/claim|Median: $53.41
1.0× median
97110Top 1%

Therapeutic exercises, each 15 min

$49K

259 claims · 0.6%

Your Cost: $189.39/claim|Median: $24.49
7.7× median
T1002Normal range

RN services, per 15 minutes

$41K

1,210 claims · 0.5%

Your Cost: $33.54/claim|Median: $37.42
0.9× median
T2016Normal range

Habilitation, residential, waiver; per diem

$22K

331 claims · 0.3%

Your Cost: $67.19/claim|Median: $331.94
0.2× median
M0299Normal range

$22K

609 claims · 0.3%

Your Cost: $35.36/claim|Median: $34.98
1.0× median
T1003Normal range

LPN/LVN services, per 15 minutes

$20K

1,542 claims · 0.3%

Your Cost: $13.09/claim|Median: $24.24
0.5× median
99213Normal range

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

$20K

438 claims · 0.3%

Your Cost: $45.50/claim|Median: $37.81
1.2× median
M0298Normal range

$13K

1,083 claims · 0.2%

Your Cost: $12.19/claim|Median: $13.85
0.9× median
Q3014Top 25%

Telehealth originating site facility fee

$13K

589 claims · 0.2%

Your Cost: $22.09/claim|Median: $15.37
1.4× median
M0372Normal range

$6K

487 claims · 0.1%

Your Cost: $12.47/claim|Median: $13.55
0.9× median
99212Normal range

Office/outpatient visit, low complexity

$6K

188 claims · 0.1%

Your Cost: $29.89/claim|Median: $25.06
1.2× median
H2017Normal range

Psychosocial rehabilitation services, per 15 min

$5K

43 claims · 0.1%

Your Cost: $112.47/claim|Median: $91.63
1.2× median
97116Top 5%

Gait training

$3K

42 claims · 0.0%

Your Cost: $76.57/claim|Median: $12.48
6.1× median
D0120Top 1%

Periodic oral evaluation, established patient

$3K

13 claims · 0.0%

Your Cost: $241.29/claim|Median: $24.34
9.9× median
99215Normal range

Office/outpatient visit, high complexity

$2K

29 claims · 0.0%

Your Cost: $70.83/claim|Median: $74.09
1.0× median
97165Top 5%

OT evaluation, low complexity

$2K

14 claims · 0.0%

Your Cost: $136.29/claim|Median: $46.78
2.9× median
M0307Normal range

$792

20 claims · 0.0%

Your Cost: $39.60/claim|Median: $29.10
1.4× median
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