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Provider 1912131368

NPI: 1912131368Share
Active Billing Period:2019-04→2024-12(69 months)

Total Paid

$18.2M

$18,215,919

Total Claims

214K

Beneficiaries

50K

4.3 claims/patient

Avg Cost/Claim

$85

Monthly Spending Trend

Yearly Spending

2019
$2.4M
+19%
2020
$2.9M
+32%
2021
$3.8M
-8%
2022
$3.5M
-5%
2023
$3.4M
-34%
2024
$2.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (97155 (Adaptive behavior treatment with protocol modification, per 15 minutes)) accounts for 23% of total spending.

97155Normal range

Adaptive behavior treatment with protocol modification, per 15 minutes

$4.2M

38K claims · 23.0%

Your Cost: $110.04/claim|Median: $146.45
0.8× median
96112Top 10%

Developmental test administration

$2.2M

7,214 claims · 12.3%

Your Cost: $311.37/claim|Median: $102.95
3.0× median
92507Top 25%

Speech/hearing/language treatment

$2.2M

30K claims · 12.0%

Your Cost: $73.73/claim|Median: $49.45
1.5× median
97530Top 25%

Therapeutic activities, each 15 min

$1.5M

20K claims · 8.1%

Your Cost: $74.95/claim|Median: $33.11
2.3× median
T1017Normal range

Targeted case management, per 15 min

$1.0M

31K claims · 5.6%

Your Cost: $33.59/claim|Median: $69.56
0.5× median
97129Top 25%

$1.0M

13K claims · 5.5%

Your Cost: $75.87/claim|Median: $17.39
4.4× median
97110Top 10%

Therapeutic exercises, each 15 min

$942K

12K claims · 5.2%

Your Cost: $77.48/claim|Median: $24.49
3.2× median
H2014Normal range

Skills training & development, per 15 min

$777K

8,105 claims · 4.3%

Your Cost: $95.82/claim|Median: $83.88
1.1× median
97130Top 25%

$730K

9,602 claims · 4.0%

Your Cost: $76.04/claim|Median: $21.60
3.5× median
97116Top 5%

Gait training

$630K

8,063 claims · 3.5%

Your Cost: $78.18/claim|Median: $12.48
6.3× median
G0177Top 10%

Training and educational services, per session

$617K

5,836 claims · 3.4%

Your Cost: $105.77/claim|Median: $8.90
11.9× median
97112Top 5%

Therapeutic procedure, neuromuscular reeducation, per 15 minutes

$471K

6,223 claims · 2.6%

Your Cost: $75.61/claim|Median: $20.04
3.8× median
92557Top 25%

Comprehensive audiometry, air, bone, and speech testing

$374K

9,603 claims · 2.1%

Your Cost: $39.00/claim|Median: $27.28
1.4× median
97533Normal range

$266K

3,928 claims · 1.5%

Your Cost: $67.82/claim|Median: $48.71
1.4× median
97156Normal range

$264K

3,099 claims · 1.5%

Your Cost: $85.24/claim|Median: $88.65
1.0× median
97153Normal range

Adaptive behavior treatment by protocol, per 15 min

$260K

2,178 claims · 1.4%

Your Cost: $119.27/claim|Median: $167.38
0.7× median
92523Top 10%

Evaluation of speech sound production with language comprehension

$157K

705 claims · 0.9%

Your Cost: $222.18/claim|Median: $110.87
2.0× median
97166Top 5%

OT evaluation, moderate complexity

$134K

893 claims · 0.7%

Your Cost: $150.43/claim|Median: $48.74
3.1× median
97127Normal range

$93K

1,238 claims · 0.5%

Your Cost: $75.40/claim|Median: $66.78
1.1× median
97165Top 5%

OT evaluation, low complexity

$85K

508 claims · 0.5%

Your Cost: $168.27/claim|Median: $46.78
3.6× median
97163Top 10%

PT evaluation, high complexity

$71K

538 claims · 0.4%

Your Cost: $132.66/claim|Median: $50.34
2.6× median
92526Top 25%

Treatment of swallowing dysfunction and/or oral function

$61K

880 claims · 0.3%

Your Cost: $68.75/claim|Median: $49.74
1.4× median
97532Top 25%

$41K

631 claims · 0.2%

Your Cost: $64.58/claim|Median: $28.76
2.2× median
97150Top 5%

Therapeutic procedure, group (2+ patients)

$36K

296 claims · 0.2%

Your Cost: $120.19/claim|Median: $12.12
9.9× median
H2027Normal range

Psychoeducational service, per 15 minutes

$24K

291 claims · 0.1%

Your Cost: $83.25/claim|Median: $82.72
1.0× median
92508Top 1%

Treatment of speech/language disorder, group, 2+ patients

$17K

177 claims · 0.1%

Your Cost: $97.15/claim|Median: $13.22
7.3× median
96152Top 25%

Health behavior intervention, individual

$15K

146 claims · 0.1%

Your Cost: $104.28/claim|Median: $20.02
5.2× median
0364TTop 5%

$11K

137 claims · 0.1%

Your Cost: $82.61/claim|Median: $21.31
3.9× median
97162Top 25%

PT evaluation, moderate complexity

$5K

63 claims · 0.0%

Your Cost: $81.71/claim|Median: $46.10
1.8× median
97535Top 10%

Self-care/home management training, per 15 minutes

$2K

31 claims · 0.0%

Your Cost: $79.00/claim|Median: $18.18
4.3× median
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