SOPHIE'S HEALTH CARE SERVICES, INC
NPI: 1124217294
· SUFFERN, NY 10901
· Home Health Agency
· NPI assigned 10/15/2007
Billing Flags
· Automated signals — not evidence of fraud
Single-Code Concentration
98% of spending on code T1019 with only 2 total codes billed. Highly concentrated billing profile.
$1.86M
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,275 |
$137K |
| 2019 |
1,023 |
$107K |
| 2020 |
461 |
$72K |
| 2021 |
248 |
$44K |
| 2022 |
2,389 |
$451K |
| 2023 |
3,024 |
$728K |
| 2024 |
1,295 |
$318K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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) |
9,344 |
463 |
$1.82M |
| T1020 |
Personal care services, per diem, 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) |
371 |
26 |
$39K |