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ROCKY MOUNTAIN HEALTH CARE SERVICES

PACE Provider Organization·COLORADO SPRINGS, CO·NPI: 1992850689Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$38.5M

$38,502,884

Total Claims

413K

Beneficiaries

219K

1.9 claims/patient

Avg Cost/Claim

$93

Monthly Spending Trend

Yearly Spending

2018
$2.8M
-42%
2019
$1.6M
-95%
2020
$83K
+4174%
2021
$3.6M
+149%
2022
$8.8M
+37%
2023
$12.1M
-22%
2024
$9.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (T2031 (Waiver services, not otherwise specified)) accounts for 45% of total spending.

T2031Normal range

Waiver services, not otherwise specified

$17.1M

11K claims · 44.5%

Your Cost: $1,553.71/claim|Median: $853.15
1.8× median
T2033Top 25%

Residential care, NOS; per diem

$4.3M

1,428 claims · 11.3%

Your Cost: $3,038.16/claim|Median: $1,051.57
2.9× median
T2030Top 5%

Supported employment, job coaching, waiver, per diem

$4.1M

2,039 claims · 10.7%

Your Cost: $2,012.20/claim|Median: $1,184.47
1.7× median
E1392Top 1%

$3.4M

14K claims · 8.8%

Your Cost: $249.21/claim|Median: $10.81
23.1× median
A9999Top 25%

$2.8M

23K claims · 7.4%

Your Cost: $125.29/claim|Median: $39.73
3.2× median
A0427Top 10%

Ambulance, ALS emergency transport Level 1

$967K

1,936 claims · 2.5%

Your Cost: $499.33/claim|Median: $164.22
3.0× median
A0429Top 10%

Ambulance, BLS emergency transport

$719K

1,738 claims · 1.9%

Your Cost: $413.58/claim|Median: $138.19
3.0× median
S5161Normal range

Emergency response system, per month

$603K

31K claims · 1.6%

Your Cost: $19.58/claim|Median: $29.97
0.7× median
E0601Top 5%

Continuous positive airway pressure (CPAP) device

$347K

4,158 claims · 0.9%

Your Cost: $83.54/claim|Median: $35.30
2.4× median
97124Top 25%

$326K

5,072 claims · 0.8%

Your Cost: $64.18/claim|Median: $17.78
3.6× median
E1399Normal range

Durable medical equipment, miscellaneous

$297K

2,450 claims · 0.8%

Your Cost: $121.24/claim|Median: $104.06
1.2× median
V2799Top 5%

$272K

1,046 claims · 0.7%

Your Cost: $260.22/claim|Median: $8.94
29.1× median
A0425Normal range

Ground mileage, per statute mile

$205K

4,998 claims · 0.5%

Your Cost: $41.00/claim|Median: $23.36
1.8× median
A0428Top 5%

Ambulance service, BLS, non-emergency transport

$155K

573 claims · 0.4%

Your Cost: $270.45/claim|Median: $58.05
4.7× median
H2018Normal range

Psychosocial rehabilitation services, per diem

$146K

327 claims · 0.4%

Your Cost: $446.41/claim|Median: $392.63
1.1× median
71046Top 1%

Chest X-ray, 2 views

$144K

581 claims · 0.4%

Your Cost: $247.33/claim|Median: $8.92
27.7× median
97813Top 5%

$138K

1,322 claims · 0.4%

Your Cost: $104.13/claim|Median: $26.35
4.0× median
98941Top 1%

Chiropractic manipulative treatment, 3-4 spinal regions

$122K

2,062 claims · 0.3%

Your Cost: $59.30/claim|Median: $20.83
2.8× median
98940Top 5%

$115K

2,176 claims · 0.3%

Your Cost: $52.86/claim|Median: $14.55
3.6× median
82306Top 25%

Vitamin D, 25 hydroxy

$108K

3,661 claims · 0.3%

Your Cost: $29.43/claim|Median: $18.18
1.6× median
11056Top 5%

Paring or cutting of benign hyperkeratotic lesions, two to four

$107K

1,477 claims · 0.3%

Your Cost: $72.19/claim|Median: $11.01
6.6× median
E0470Top 25%

$102K

762 claims · 0.3%

Your Cost: $134.22/claim|Median: $81.45
1.6× median
80307Top 25%

Drug test, presumptive, by chemistry analyzers

$98K

1,599 claims · 0.3%

Your Cost: $61.20/claim|Median: $35.43
1.7× median
11721Top 5%

$89K

2,006 claims · 0.2%

Your Cost: $44.60/claim|Median: $8.56
5.2× median
97012Top 5%

Mechanical traction therapy

$77K

3,722 claims · 0.2%

Your Cost: $20.75/claim|Median: $8.34
2.5× median
84443Top 25%

Thyroid stimulating hormone (TSH)

$69K

4,160 claims · 0.2%

Your Cost: $16.67/claim|Median: $9.87
1.7× median
G0480Top 5%

Drug test, definitive, 1-7 drug classes

$67K

585 claims · 0.2%

Your Cost: $113.84/claim|Median: $37.56
3.0× median
98960Top 10%

$64K

979 claims · 0.2%

Your Cost: $65.18/claim|Median: $12.74
5.1× median
97140Top 25%

Manual therapy techniques, per 15 minutes

$63K

2,623 claims · 0.2%

Your Cost: $23.92/claim|Median: $16.79
1.4× median
92004Top 5%

Ophthalmological exam, comprehensive, new patient

$60K

467 claims · 0.2%

Your Cost: $128.85/claim|Median: $59.72
2.2× median
K0739Top 1%

$58K

81 claims · 0.1%

Your Cost: $709.90/claim|Median: $34.09
20.8× median
85025Top 25%

Complete blood count (CBC) with differential, automated

$55K

7,194 claims · 0.1%

Your Cost: $7.67/claim|Median: $4.71
1.6× median
83036Top 25%

Hemoglobin A1c (glycated hemoglobin)

$54K

5,568 claims · 0.1%

Your Cost: $9.65/claim|Median: $5.50
1.8× median
82607Top 25%

Cyanocobalamin (vitamin B-12)

$52K

3,468 claims · 0.1%

Your Cost: $15.00/claim|Median: $8.72
1.7× median
80061Top 25%

Lipid panel

$48K

3,634 claims · 0.1%

Your Cost: $13.32/claim|Median: $8.41
1.6× median
G0483Top 5%

Drug test, definitive, 22+ drug classes

$46K

207 claims · 0.1%

Your Cost: $224.40/claim|Median: $90.89
2.5× median
U0003Top 25%

Infectious disease detection (COVID-19)

$46K

581 claims · 0.1%

Your Cost: $79.74/claim|Median: $63.08
1.3× median
80053Top 25%

Comprehensive metabolic panel

$43K

4,125 claims · 0.1%

Your Cost: $10.51/claim|Median: $7.24
1.5× median
V5261Top 25%

$42K

20 claims · 0.1%

Your Cost: $2,084.30/claim|Median: $848.60
2.5× median
82728Top 25%

Ferritin

$41K

3,052 claims · 0.1%

Your Cost: $13.55/claim|Median: $6.00
2.3× median
L2999Top 1%

$39K

134 claims · 0.1%

Your Cost: $289.78/claim|Median: $47.06
6.2× median
97026Top 1%

$36K

1,449 claims · 0.1%

Your Cost: $24.86/claim|Median: $4.04
6.2× median
93000Top 1%

Electrocardiogram, complete, with interpretation and report

$36K

240 claims · 0.1%

Your Cost: $150.00/claim|Median: $9.70
15.5× median
11057Top 5%

$35K

482 claims · 0.1%

Your Cost: $72.64/claim|Median: $15.10
4.8× median
A4615Top 1%

$35K

2,387 claims · 0.1%

Your Cost: $14.54/claim|Median: $0.45
32.3× median
A5500Top 1%

Diabetic therapeutic shoe, depth, each

$35K

214 claims · 0.1%

Your Cost: $161.63/claim|Median: $33.21
4.9× median
80048Normal range

Basic metabolic panel

$34K

4,058 claims · 0.1%

Your Cost: $8.39/claim|Median: $5.78
1.5× median
A0130Normal range

Non-emergency wheelchair van transport

$33K

17K claims · 0.1%

Your Cost: $1.95/claim|Median: $29.37
0.1× median
92014Top 5%

Ophthalmological exam, comprehensive, established patient

$32K

283 claims · 0.1%

Your Cost: $111.85/claim|Median: $47.08
2.4× median
99213Normal range

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

$30K

1,873 claims · 0.1%

Your Cost: $16.00/claim|Median: $37.81
0.4× median

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