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VERTEX LLC

Clinic/Center, Rehabilitation, Substance Use Disorder·BRONX, NY·NPI: 1831377407Share

Compared to Clinic/Center, Rehabilitation, Substance Use Disorder Peers

Total spending distribution among 13 providers in this specialty

P25MedianP75P90

This provider's total spending of $24.6M is at the 75th percentile among 13 Clinic/Center, Rehabilitation, Substance Use Disorder providers.

Active Billing Period:2019-012024-12(68 months)

Total Paid

$24.6M

$24,563,266

Total Claims

235K

Beneficiaries

56K

4.2 claims/patient

Avg Cost/Claim

$105

Monthly Spending Trend

Yearly Spending

2019
$489K
+428%
2020
$2.6M
+131%
2021
$6.0M
-17%
2022
$5.0M
+0%
2023
$5.0M
+12%
2024
$5.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 8 distinct procedure codes. The top code (G0397) accounts for 43% of total spending.

G0397Normal range

$10.5M

68K claims · 42.8%

Your Cost: $155.63/claim|Median: $142.31
1.1× median
G0396Top 25%

Alcohol/substance abuse structured assessment, 15-30 minutes

$6.9M

60K claims · 27.9%

Your Cost: $113.31/claim|Median: $40.58
2.8× median
H0005Top 25%

Alcohol and/or drug services, group counseling

$6.1M

100K claims · 24.7%

Your Cost: $60.89/claim|Median: $47.35
1.3× median
H0001Top 25%

Alcohol and/or drug assessment

$803K

4,670 claims · 3.3%

Your Cost: $171.95/claim|Median: $94.22
1.8× median
99202Top 5%

Office/outpatient visit, new patient, low complexity

$266K

1,808 claims · 1.1%

Your Cost: $146.91/claim|Median: $40.11
3.7× median
99201Top 25%

Office/outpatient visit, new patient, straightforward

$40K

428 claims · 0.2%

Your Cost: $93.19/claim|Median: $27.38
3.4× median
99203Top 5%

Office/outpatient visit, new patient, low-mod complexity

$29K

225 claims · 0.1%

Your Cost: $126.99/claim|Median: $57.85
2.2× median
99406Top 5%

$663

30 claims · 0.0%

Your Cost: $22.10/claim|Median: $6.53
3.4× median

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