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POTOMAC HIGHLANDS GUILD

Community/Behavioral Health·PETERSBURG, WV·NPI: 1720273170Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $38.8M is at the 50th percentile among 218 Community/Behavioral Health providers.

Active Billing Period:2018-012024-12(84 months)

Total Paid

$38.8M

$38,848,606

Total Claims

213K

Beneficiaries

44K

4.8 claims/patient

Avg Cost/Claim

$182

Monthly Spending Trend

Yearly Spending

2018
$5.4M
+1%
2019
$5.5M
+7%
2020
$5.8M
+9%
2021
$6.4M
+9%
2022
$6.9M
-28%
2023
$5.0M
-22%
2024
$3.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 10 distinct procedure codes. The top code (S5125 (Attendant care services, per 15 min)) accounts for 71% of total spending.

S5125Top 10%

Attendant care services, per 15 min

$27.5M

86K claims · 70.8%

Your Cost: $319.59/claim|Median: $82.34
3.9× median
T1005Top 1%

Respite care services, per 15 minutes

$4.8M

4,236 claims · 12.5%

Your Cost: $1,142.03/claim|Median: $71.40
16.0× median
T2021Normal range

Day habilitation, waiver; per 15 min

$2.1M

39K claims · 5.3%

Your Cost: $53.22/claim|Median: $150.51
0.4× median
A0160Top 10%

$1.4M

14K claims · 3.5%

Your Cost: $96.87/claim|Median: $12.60
7.7× median
G9002Top 25%

Coordinated care fee, maintenance period

$1.2M

6,212 claims · 3.2%

Your Cost: $200.86/claim|Median: $108.80
1.8× median
T1016Normal range

Case management, each 15 min

$856K

25K claims · 2.2%

Your Cost: $33.61/claim|Median: $49.62
0.7× median
A0120Normal range

Non-emergency mini-bus transport

$407K

23K claims · 1.0%

Your Cost: $17.76/claim|Median: $16.09
1.1× median
T1002Normal range

RN services, per 15 minutes

$292K

9,101 claims · 0.8%

Your Cost: $32.12/claim|Median: $37.42
0.9× median
T1003Normal range

LPN/LVN services, per 15 minutes

$184K

4,775 claims · 0.5%

Your Cost: $38.46/claim|Median: $24.24
1.6× median
T2024Normal range

Supported employment, waiver, per diem

$99K

1,751 claims · 0.3%

Your Cost: $56.71/claim|Median: $259.38
0.2× median