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TOTAL LONGTERM CARE, INC

PACE Provider Organization·LAKEWOOD, CO·NPI: 1639770183Share
Active Billing Period:2019-04→2024-11(50 months)

Total Paid

$20.9M

$20,916,004

Total Claims

86K

Beneficiaries

70K

1.2 claims/patient

Avg Cost/Claim

$242

Monthly Spending Trend

Yearly Spending

2019
$8K
+43%
2020
$11K
+42050%
2021
$4.5M
+14%
2022
$5.2M
+116%
2023
$11.2M
-100%
2024
$4K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (T2030 (Supported employment, job coaching, waiver, per diem)) accounts for 65% of total spending.

T2030Top 25%

Supported employment, job coaching, waiver, per diem

$13.6M

9,615 claims · 65.2%

Your Cost: $1,418.80/claim|Median: $1,184.47
1.2× median
T2031Normal range

Waiver services, not otherwise specified

$4.0M

2,505 claims · 19.2%

Your Cost: $1,601.79/claim|Median: $853.15
1.9× median
A9999Normal range

$973K

11K claims · 4.7%

Your Cost: $90.11/claim|Median: $39.73
2.3× median
E1392Top 1%

$678K

5,674 claims · 3.2%

Your Cost: $119.41/claim|Median: $10.81
11.0× median
A0427Top 25%

Ambulance, ALS emergency transport Level 1

$178K

662 claims · 0.9%

Your Cost: $269.22/claim|Median: $164.22
1.6× median
S5161Normal range

Emergency response system, per month

$167K

11K claims · 0.8%

Your Cost: $15.71/claim|Median: $29.97
0.5× median
E1390Top 25%

Oxygen concentrator, single delivery port

$163K

1,986 claims · 0.8%

Your Cost: $81.89/claim|Median: $45.11
1.8× median
T2033Normal range

Residential care, NOS; per diem

$161K

137 claims · 0.8%

Your Cost: $1,171.99/claim|Median: $1,051.57
1.1× median
E0601Top 25%

Continuous positive airway pressure (CPAP) device

$136K

2,617 claims · 0.7%

Your Cost: $52.15/claim|Median: $35.30
1.5× median
99213Normal range

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

$134K

3,745 claims · 0.6%

Your Cost: $35.67/claim|Median: $37.81
0.9× median
11719Top 10%

$103K

5,134 claims · 0.5%

Your Cost: $20.01/claim|Median: $1.95
10.3× median
E0277Normal range

$80K

1,165 claims · 0.4%

Your Cost: $69.04/claim|Median: $92.82
0.7× median
A0428Top 25%

Ambulance service, BLS, non-emergency transport

$39K

288 claims · 0.2%

Your Cost: $135.73/claim|Median: $58.05
2.3× median
A0425Normal range

Ground mileage, per statute mile

$37K

1,904 claims · 0.2%

Your Cost: $19.22/claim|Median: $23.36
0.8× median
E0265Normal range

$32K

1,040 claims · 0.2%

Your Cost: $30.39/claim|Median: $41.12
0.7× median
84443Normal range

Thyroid stimulating hormone (TSH)

$25K

1,747 claims · 0.1%

Your Cost: $14.09/claim|Median: $9.87
1.4× median
82306Normal range

Vitamin D, 25 hydroxy

$24K

920 claims · 0.1%

Your Cost: $26.25/claim|Median: $18.18
1.4× median
80053Normal range

Comprehensive metabolic panel

$21K

2,502 claims · 0.1%

Your Cost: $8.50/claim|Median: $7.24
1.2× median
E0439Top 25%

$18K

163 claims · 0.1%

Your Cost: $112.55/claim|Median: $56.10
2.0× median
D9410Top 25%

$18K

186 claims · 0.1%

Your Cost: $97.26/claim|Median: $28.00
3.5× median
85025Normal range

Complete blood count (CBC) with differential, automated

$18K

3,014 claims · 0.1%

Your Cost: $5.98/claim|Median: $4.71
1.3× median
83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$16K

2,036 claims · 0.1%

Your Cost: $7.85/claim|Median: $5.50
1.4× median
P9604Top 1%

$15K

232 claims · 0.1%

Your Cost: $64.48/claim|Median: $0.81
79.6× median
U0003Top 25%

Infectious disease detection (COVID-19)

$14K

187 claims · 0.1%

Your Cost: $76.64/claim|Median: $63.08
1.2× median
11721Top 5%

$12K

310 claims · 0.1%

Your Cost: $38.58/claim|Median: $8.56
4.5× median
E0434Normal range

$12K

928 claims · 0.1%

Your Cost: $12.55/claim|Median: $17.56
0.7× median
98960Top 25%

$12K

290 claims · 0.1%

Your Cost: $40.03/claim|Median: $12.74
3.1× median
80061Normal range

Lipid panel

$10K

900 claims · 0.0%

Your Cost: $11.41/claim|Median: $8.41
1.4× median
82607Normal range

Cyanocobalamin (vitamin B-12)

$10K

787 claims · 0.0%

Your Cost: $12.50/claim|Median: $8.72
1.4× median
K0001Normal range

Standard wheelchair

$9K

1,800 claims · 0.0%

Your Cost: $5.13/claim|Median: $12.27
0.4× median
92014Top 25%

Ophthalmological exam, comprehensive, established patient

$8K

110 claims · 0.0%

Your Cost: $76.95/claim|Median: $47.08
1.6× median
A4615Top 10%

$8K

1,539 claims · 0.0%

Your Cost: $5.36/claim|Median: $0.45
11.9× median
E0431Top 25%

Portable gaseous oxygen system, rental

$8K

520 claims · 0.0%

Your Cost: $15.85/claim|Median: $10.37
1.5× median
86480Top 5%

Tuberculosis test, cell-mediated immunity

$8K

103 claims · 0.0%

Your Cost: $75.92/claim|Median: $38.35
2.0× median
V2744Top 1%

$8K

76 claims · 0.0%

Your Cost: $98.68/claim|Median: $10.12
9.8× median
V2203Top 5%

$7K

79 claims · 0.0%

Your Cost: $90.82/claim|Median: $29.84
3.0× median
K0045Top 25%

$7K

824 claims · 0.0%

Your Cost: $8.59/claim|Median: $4.08
2.1× median
80048Normal range

Basic metabolic panel

$7K

1,035 claims · 0.0%

Your Cost: $6.78/claim|Median: $5.78
1.2× median
E0444Normal range

$7K

156 claims · 0.0%

Your Cost: $44.53/claim|Median: $46.55
1.0× median
V2020Top 5%

Frames, purchases

$6K

99 claims · 0.0%

Your Cost: $62.51/claim|Median: $19.33
3.2× median
V5160Normal range

$6K

26 claims · 0.0%

Your Cost: $230.77/claim|Median: $309.52
0.7× median
V2781Top 5%

$5K

36 claims · 0.0%

Your Cost: $150.00/claim|Median: $29.17
5.1× median
V5299Normal range

$5K

318 claims · 0.0%

Your Cost: $15.13/claim|Median: $17.60
0.9× median
E0562Normal range

Humidifier, heated, used with positive airway pressure device

$4K

234 claims · 0.0%

Your Cost: $18.64/claim|Median: $18.68
1.0× median
E0443Top 25%

$4K

89 claims · 0.0%

Your Cost: $45.25/claim|Median: $12.89
3.5× median
U0005Top 25%

Infectious disease detection, COVID-19, antigen

$4K

158 claims · 0.0%

Your Cost: $24.50/claim|Median: $15.76
1.6× median
E0570Normal range

Nebulizer, with compressor

$4K

325 claims · 0.0%

Your Cost: $11.62/claim|Median: $16.16
0.7× median
87086Normal range

Urine culture, colony count, with identification

$4K

597 claims · 0.0%

Your Cost: $6.05/claim|Median: $5.31
1.1× median
92015Top 1%

Determination of refractive state

$3K

52 claims · 0.0%

Your Cost: $63.00/claim|Median: $10.36
6.1× median
92591Top 25%

$3K

42 claims · 0.0%

Your Cost: $64.29/claim|Median: $36.39
1.8× median

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