COUNTRY PINES PHASE II LC
NPI: 1104037563
· CLINTON, UT 84015
· Assisted Living Facility
· NPI assigned 05/25/2007
Billing Flags
· Automated signals — not evidence of fraud
Single-Code Concentration
100% of spending on code H0043 with only 1 total codes billed. Highly concentrated billing profile.
$1.23M
Total Medicaid Paid
1,046
Beneficiary Records
Provider Details
| Authorized Official | MCCLELLAN, MYRNA (ADMINISTRATOR) |
| NPI Enumeration Date | 05/25/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
195 |
$210K |
| 2019 |
216 |
$219K |
| 2020 |
241 |
$249K |
| 2021 |
232 |
$261K |
| 2022 |
511 |
$217K |
| 2023 |
119 |
$75K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| H0043 |
Supported housing, per diem |
1,514 |
1,046 |
$1.23M |