COUNTRY CLUB MANOR
NPI: 1033259213
· SACRAMENTO, CA 95825
· Assisted Living Facility
· NPI assigned 02/07/2007
Billing Flags
· Automated signals — not evidence of fraud
Single-Code Concentration
100% of spending on code T2031 with only 1 total codes billed. Highly concentrated billing profile.
$2.95M
Total Medicaid Paid
Provider Details
| Authorized Official | DRAKE, STUART (EXEC. ADMINISTRATOR) |
| NPI Enumeration Date | 02/07/2007 |
Related Entities
Other providers sharing the same authorized official: DRAKE, STUART
| Provider | City | State | Total Paid |
|---|
| WALNUT HOUSE |
CARMICHAEL |
CA |
$1.08M |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,002 |
$774K |
| 2019 |
813 |
$937K |
| 2020 |
817 |
$1.02M |
| 2021 |
165 |
$221K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2031 |
Assisted living; waiver, per diem |
2,797 |
1,326 |
$2.95M |