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TOTAL LONGTERM CARE, INC.

PACE Provider Organization·AURORA, CO·NPI: 1750987053Share
Active Billing Period:2019-04→2024-11(53 months)

Total Paid

$22.5M

$22,466,453

Total Claims

98K

Beneficiaries

66K

1.5 claims/patient

Avg Cost/Claim

$229

Monthly Spending Trend

Yearly Spending

2019
$58K
-93%
2020
$4K
+62329%
2021
$2.7M
+357%
2022
$12.4M
-64%
2023
$4.4M
-33%
2024
$2.9M

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 76% of total spending.

T2030Top 5%

Supported employment, job coaching, waiver, per diem

$17.1M

7,257 claims · 76.3%

Your Cost: $2,361.10/claim|Median: $1,184.47
2.0× median
T2031Top 10%

Waiver services, not otherwise specified

$1.3M

453 claims · 5.8%

Your Cost: $2,900.00/claim|Median: $853.15
3.4× median
A9999Top 25%

$869K

6,136 claims · 3.9%

Your Cost: $141.66/claim|Median: $39.73
3.6× median
E1392Top 1%

$490K

2,537 claims · 2.2%

Your Cost: $192.96/claim|Median: $10.81
17.9× median
E1390Top 10%

Oxygen concentrator, single delivery port

$336K

3,291 claims · 1.5%

Your Cost: $102.10/claim|Median: $45.11
2.3× median
A0427Top 10%

Ambulance, ALS emergency transport Level 1

$295K

611 claims · 1.3%

Your Cost: $482.68/claim|Median: $164.22
2.9× median
S5161Normal range

Emergency response system, per month

$176K

6,661 claims · 0.8%

Your Cost: $26.35/claim|Median: $29.97
0.9× median
11719Top 5%

$170K

5,118 claims · 0.8%

Your Cost: $33.15/claim|Median: $1.95
17.0× median
E0601Top 5%

Continuous positive airway pressure (CPAP) device

$169K

2,003 claims · 0.8%

Your Cost: $84.21/claim|Median: $35.30
2.4× median
U0003Top 25%

Infectious disease detection (COVID-19)

$166K

2,153 claims · 0.7%

Your Cost: $77.29/claim|Median: $63.08
1.2× median
A0429Top 10%

Ambulance, BLS emergency transport

$108K

262 claims · 0.5%

Your Cost: $412.15/claim|Median: $138.19
3.0× median
E0277Normal range

$93K

844 claims · 0.4%

Your Cost: $110.15/claim|Median: $92.82
1.2× median
99213Normal range

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

$85K

1,907 claims · 0.4%

Your Cost: $44.77/claim|Median: $37.81
1.2× median
A0428Top 5%

Ambulance service, BLS, non-emergency transport

$74K

297 claims · 0.3%

Your Cost: $248.84/claim|Median: $58.05
4.3× median
T2033Normal range

Residential care, NOS; per diem

$72K

50 claims · 0.3%

Your Cost: $1,443.46/claim|Median: $1,051.57
1.4× median
A0425Normal range

Ground mileage, per statute mile

$68K

1,918 claims · 0.3%

Your Cost: $35.64/claim|Median: $23.36
1.5× median
R0070Top 1%

$58K

261 claims · 0.3%

Your Cost: $221.90/claim|Median: $18.06
12.3× median
90837Top 25%

Psychotherapy, 60 minutes

$57K

527 claims · 0.3%

Your Cost: $108.97/claim|Median: $85.66
1.3× median
U0005Top 10%

Infectious disease detection, COVID-19, antigen

$51K

1,963 claims · 0.2%

Your Cost: $25.82/claim|Median: $15.76
1.6× median
E0434Top 5%

$44K

1,095 claims · 0.2%

Your Cost: $40.02/claim|Median: $17.56
2.3× median
82306Top 10%

Vitamin D, 25 hydroxy

$42K

1,174 claims · 0.2%

Your Cost: $35.79/claim|Median: $18.18
2.0× median
D9410Top 10%

$42K

398 claims · 0.2%

Your Cost: $104.44/claim|Median: $28.00
3.7× median
84443Top 10%

Thyroid stimulating hormone (TSH)

$32K

1,517 claims · 0.1%

Your Cost: $20.80/claim|Median: $9.87
2.1× median
80053Top 25%

Comprehensive metabolic panel

$28K

2,205 claims · 0.1%

Your Cost: $12.47/claim|Median: $7.24
1.7× median
E0439Top 25%

$26K

226 claims · 0.1%

Your Cost: $114.48/claim|Median: $56.10
2.0× median
83036Top 10%

Hemoglobin A1c (glycated hemoglobin)

$23K

1,930 claims · 0.1%

Your Cost: $11.68/claim|Median: $5.50
2.1× median
98960Top 5%

$21K

146 claims · 0.1%

Your Cost: $144.25/claim|Median: $12.74
11.3× median
85025Top 25%

Complete blood count (CBC) with differential, automated

$20K

2,439 claims · 0.1%

Your Cost: $8.32/claim|Median: $4.71
1.8× median
80061Top 10%

Lipid panel

$20K

1,240 claims · 0.1%

Your Cost: $16.26/claim|Median: $8.41
1.9× median
99309Top 1%

Nursing facility care, subsequent, low complexity

$20K

224 claims · 0.1%

Your Cost: $87.64/claim|Median: $14.00
6.3× median
E0443Top 10%

$19K

322 claims · 0.1%

Your Cost: $58.13/claim|Median: $12.89
4.5× median
E0431Top 25%

Portable gaseous oxygen system, rental

$17K

909 claims · 0.1%

Your Cost: $19.01/claim|Median: $10.37
1.8× median
99308Top 1%

Nursing facility care, subsequent, straightforward

$15K

215 claims · 0.1%

Your Cost: $68.71/claim|Median: $9.79
7.0× median
11721Top 5%

$15K

308 claims · 0.1%

Your Cost: $47.75/claim|Median: $8.56
5.6× median
E0466Top 1%

Home ventilator, any type, used with non-invasive interface

$14K

14 claims · 0.1%

Your Cost: $1,014.66/claim|Median: $317.50
3.2× median
A4615Top 10%

$14K

2,617 claims · 0.1%

Your Cost: $5.16/claim|Median: $0.45
11.5× median
T1017Normal range

Targeted case management, per 15 min

$12K

460 claims · 0.1%

Your Cost: $26.36/claim|Median: $69.56
0.4× median
E0562Normal range

Humidifier, heated, used with positive airway pressure device

$11K

596 claims · 0.1%

Your Cost: $18.98/claim|Median: $18.68
1.0× median
E0444Normal range

$11K

223 claims · 0.0%

Your Cost: $50.34/claim|Median: $46.55
1.1× median
A0433Top 5%

$11K

16 claims · 0.0%

Your Cost: $694.05/claim|Median: $207.46
3.3× median
E0265Normal range

$10K

262 claims · 0.0%

Your Cost: $38.17/claim|Median: $41.12
0.9× median
E0442Normal range

$10K

420 claims · 0.0%

Your Cost: $23.20/claim|Median: $31.85
0.7× median
71046Top 5%

Chest X-ray, 2 views

$9K

84 claims · 0.0%

Your Cost: $109.43/claim|Median: $8.92
12.3× median
82607Top 10%

Cyanocobalamin (vitamin B-12)

$9K

471 claims · 0.0%

Your Cost: $18.42/claim|Median: $8.72
2.1× median
Q0092Top 1%

$8K

291 claims · 0.0%

Your Cost: $29.05/claim|Median: $2.34
12.4× median
E0570Normal range

Nebulizer, with compressor

$8K

715 claims · 0.0%

Your Cost: $11.59/claim|Median: $16.16
0.7× median
E0184Top 25%

$8K

231 claims · 0.0%

Your Cost: $34.09/claim|Median: $19.54
1.7× median
80048Top 25%

Basic metabolic panel

$7K

734 claims · 0.0%

Your Cost: $9.96/claim|Median: $5.78
1.7× median
99214Normal range

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

$7K

492 claims · 0.0%

Your Cost: $14.05/claim|Median: $53.41
0.3× median
92015Top 1%

Determination of refractive state

$7K

150 claims · 0.0%

Your Cost: $45.68/claim|Median: $10.36
4.4× median

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