RIO GRANDE VALLEY PHC/CBA, LLC
NPI: 1013153600
· MCALLEN, TX 78504
· Developmentally Disabled Services Day Training Agency
· NPI assigned 01/02/2009
Billing Flags
· Automated signals — not evidence of fraud
Single-Code Concentration
96% of spending on code S5125 with only 3 total codes billed. Highly concentrated billing profile.
$65.15M
Total Medicaid Paid
Provider Details
| Authorized Official | GARZA, MAYTE (ADMINISTRATOR/CEO) |
| NPI Enumeration Date | 01/02/2009 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
10,814 |
$2.31M |
| 2019 |
15,050 |
$2.88M |
| 2020 |
118,745 |
$5.99M |
| 2021 |
233,038 |
$11.39M |
| 2022 |
221,376 |
$12.06M |
| 2023 |
243,603 |
$13.20M |
| 2024 |
281,519 |
$17.31M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5125 |
Attendant care services; per 15 minutes |
1,053,918 |
49,837 |
$62.55M |
| T1005 |
Respite care services, up to 15 minutes |
35,004 |
1,998 |
$1.40M |
| T1019 |
Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant) |
35,223 |
1,536 |
$1.19M |