Hernandez, Sylvia
Hernandez, Sylvia was paid $3.45M by Medicaid between Oct 2020 and Oct 2024, across 2 billing codes. Its largest line is 97530, Therapeutic activities, direct patient contact, each 15 minutes — 100% of everything it billed.
33Billing provider infoHERNANDEZ, SYLVIA
PHARR, TX 78577
PHARR, TX 78577
33aNPI1053565002assigned 11/04/2008
33bProvider typeOccupational Therapist
28Total paid$3.45M
24GClaims38,450
24DCodes billed2
24AFirst – last monthOct 2020 – Oct 2024
Compared with peers
Next to other Occupational Therapist providers in Texas
Rank by total paid#8 of 299
Median peer was paid$93K
This provider vs. median37×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Single-Code Concentration100% of spending on code 97530 with only 2 total codes billed. Highly concentrated billing profile.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2020 | 1,845 | $160K | |
| 2021 | 9,955 | $842K | |
| 2022 | 8,450 | $716K | |
| 2023 | 10,804 | $1.08M | |
| 2024incomplete | 7,396 | $651K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 100% | 38,399 | 6,182 | $3.45M |
| 97168 | <1% | 51 | 50 | $4K |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.