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Provider 1861709586

NPI: 1861709586Share
Active Billing Period:2018-12→2024-12(62 months)

Total Paid

$10.2M

$10,230,524

Total Claims

78K

Beneficiaries

8,826

8.9 claims/patient

Avg Cost/Claim

$131

Monthly Spending Trend

Yearly Spending

2018
$2K
+1135%
2019
$19K
+58%
2020
$30K
+5865%
2021
$1.8M
+52%
2022
$2.7M
-6%
2023
$2.6M
+21%
2024
$3.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 20 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 53% of total spending.

H2016Normal range

Comprehensive community support services, per 15 min

$5.4M

11K claims · 53.0%

Your Cost: $472.15/claim|Median: $321.53
1.5× median
T2016Normal range

Habilitation, residential, waiver; per diem

$1.1M

6,203 claims · 10.3%

Your Cost: $170.34/claim|Median: $331.94
0.5× median
M0123Top 1%

$786K

10K claims · 7.7%

Your Cost: $76.14/claim|Median: $76.14
1.0× median
H2014Normal range

Skills training & development, per 15 min

$762K

21K claims · 7.4%

Your Cost: $36.28/claim|Median: $83.88
0.4× median
M0125Top 1%

$485K

5,151 claims · 4.7%

Your Cost: $94.07/claim|Median: $94.07
1.0× median
M0122Top 1%

$402K

5,535 claims · 3.9%

Your Cost: $72.56/claim|Median: $72.56
1.0× median
M0354Top 25%

$357K

2,814 claims · 3.5%

Your Cost: $126.86/claim|Median: $90.61
1.4× median
90837Normal range

Psychotherapy, 60 minutes

$216K

2,971 claims · 2.1%

Your Cost: $72.80/claim|Median: $85.66
0.8× median
T2020Normal range

Day habilitation, waiver; per diem

$167K

1,384 claims · 1.6%

Your Cost: $120.94/claim|Median: $87.34
1.4× median
M0116Normal range

$159K

5,033 claims · 1.6%

Your Cost: $31.67/claim|Median: $32.07
1.0× median
H2019Normal range

Therapeutic behavioral services, per 15 min

$105K

835 claims · 1.0%

Your Cost: $125.58/claim|Median: $84.12
1.5× median
T1002Top 25%

RN services, per 15 minutes

$83K

1,099 claims · 0.8%

Your Cost: $75.57/claim|Median: $37.42
2.0× median
M0133Normal range

$67K

760 claims · 0.7%

Your Cost: $88.56/claim|Median: $84.70
1.0× median
M0299Top 25%

$45K

909 claims · 0.4%

Your Cost: $49.94/claim|Median: $34.98
1.4× median
M0115Normal range

$39K

1,398 claims · 0.4%

Your Cost: $28.13/claim|Median: $29.58
1.0× median
T1003Normal range

LPN/LVN services, per 15 minutes

$30K

568 claims · 0.3%

Your Cost: $53.34/claim|Median: $24.24
2.2× median
M0298Top 10%

$21K

724 claims · 0.2%

Your Cost: $28.62/claim|Median: $13.85
2.1× median
S8990Top 5%

$20K

62 claims · 0.2%

Your Cost: $325.58/claim|Median: $78.36
4.2× median
D0120Top 1%

Periodic oral evaluation, established patient

$4K

12 claims · 0.0%

Your Cost: $318.43/claim|Median: $24.34
13.1× median
M0248Normal range

$47

16 claims · 0.0%

Your Cost: $2.91/claim|Median: $5.31
0.5× median
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