Serna, Carlos
Serna, Carlos was paid $4.29M by Medicaid between Jan 2018 and Nov 2024, across 1 billing code. Its largest line is T2022, Case management, per month — 100% of everything it billed.
33Billing provider infoSERNA, CARLOS
LEXINGTON, KY 40508
LEXINGTON, KY 40508
33aNPI1063710317assigned 03/10/2011
33bProvider typeCase Manager/Care Coordinator
28Total paid$4.29M
24GClaims11,604
24DCodes billed1
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Case Manager/Care Coordinator providers in Kentucky
Rank by total paid#2 of 16
Median peer was paid$1.01M
This provider vs. median4.2×
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 T2022 with only 1 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 | |
|---|---|---|---|
| 2018 | 1,479 | $490K | |
| 2019 | 1,530 | $535K | |
| 2020 | 1,502 | $523K | |
| 2021 | 1,508 | $528K | |
| 2022 | 1,928 | $726K | |
| 2023 | 2,039 | $812K | |
| 2024incomplete | 1,618 | $676K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T2022 | Case management, per month | 100% | 11,604 | 11,512 | $4.29M |
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.