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Provider 1891104386

NPI: 1891104386Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$12.4M

$12,412,240

Total Claims

270K

Beneficiaries

77K

3.5 claims/patient

Avg Cost/Claim

$46

Monthly Spending Trend

Yearly Spending

2018
$744K
+37%
2019
$1.0M
+169%
2020
$2.7M
-31%
2021
$1.9M
-45%
2022
$1.1M
+150%
2023
$2.6M
-12%
2024
$2.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 27 distinct procedure codes. The top code (T1016 (Case management, each 15 min)) accounts for 86% of total spending.

T1016Normal range

Case management, each 15 min

$10.6M

251K claims · 85.7%

Your Cost: $42.35/claim|Median: $49.62
0.9× median
S9123Normal range

Nursing care, in the home, by RN, per 15 minutes

$1.3M

9,149 claims · 10.6%

Your Cost: $144.02/claim|Median: $124.86
1.2× median
S0250Normal range

$365K

4,389 claims · 2.9%

Your Cost: $83.22/claim|Median: $66.58
1.2× median
S5190Top 25%

Wellness assessment, performed by non-physician

$48K

440 claims · 0.4%

Your Cost: $108.75/claim|Median: $33.67
3.2× median
S9447Normal range

$8K

97 claims · 0.1%

Your Cost: $78.24/claim|Median: $89.99
0.9× median
83655Normal range

$6K

754 claims · 0.1%

Your Cost: $8.57/claim|Median: $10.49
0.8× median
96110Normal range

Developmental screening, per standardized instrument

$6K

665 claims · 0.0%

Your Cost: $8.57/claim|Median: $9.10
0.9× median
91322Top 25%

$5K

38 claims · 0.0%

Your Cost: $130.69/claim|Median: $76.28
1.7× median
96127Normal range

Brief emotional/behavioral assessment, per standardized instrument

$4K

1,001 claims · 0.0%

Your Cost: $4.05/claim|Median: $3.67
1.1× median
T1015Normal range

Clinic visit/encounter, all-inclusive

$2K

68 claims · 0.0%

Your Cost: $32.90/claim|Median: $121.16
0.3× median
90662Top 5%

$2K

33 claims · 0.0%

Your Cost: $65.81/claim|Median: $6.55
10.0× median
96161Top 25%

$2K

257 claims · 0.0%

Your Cost: $6.76/claim|Median: $2.49
2.7× median
36416Normal range

$2K

816 claims · 0.0%

Your Cost: $2.09/claim|Median: $1.31
1.6× median
T1002Normal range

RN services, per 15 minutes

$611

12 claims · 0.0%

Your Cost: $50.90/claim|Median: $37.42
1.4× median
T1013Normal range

Sign language or oral interpretive services, per 15 minutes

$559

17 claims · 0.0%

Your Cost: $32.87/claim|Median: $17.67
1.9× median
90471Top 25%

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$523

35 claims · 0.0%

Your Cost: $14.93/claim|Median: $9.80
1.5× median
G0008Top 10%

$509

28 claims · 0.0%

Your Cost: $18.19/claim|Median: $2.54
7.2× median
90686Top 25%

Influenza virus vaccine, quadrivalent, preservative-free, IM

$249

14 claims · 0.0%

Your Cost: $17.78/claim|Median: $7.18
2.5× median
S0302Top 25%

$230

16 claims · 0.0%

Your Cost: $14.34/claim|Median: $9.05
1.6× median
85018Top 25%

$150

56 claims · 0.0%

Your Cost: $2.67/claim|Median: $1.71
1.6× median
92552Normal range

Pure tone audiometry, air only, each ear

$55

16 claims · 0.0%

Your Cost: $3.44/claim|Median: $12.63
0.3× median
90480Normal range

$35

38 claims · 0.0%

Your Cost: $0.92/claim|Median: $25.29
0.0× median
99188Normal range

$23

13 claims · 0.0%

Your Cost: $1.76/claim|Median: $12.80
0.1× median
99173Normal range

$7

16 claims · 0.0%

Your Cost: $0.42/claim|Median: $2.16
0.2× median
G9002Normal range

Coordinated care fee, maintenance period

$0

268 claims · 0.0%

Your Cost: $0.00/claim|Median: $108.80
X5622Normal range

$0

17 claims · 0.0%

Your Cost: $0.00/claim|Median: $52.61
G9012Normal range

Other specified case management service, per 15 minutes

$0

49 claims · 0.0%

Your Cost: $0.00/claim|Median: $137.85
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