Direct Care Prenatal LLC

Direct Care Prenatal LLC was paid $1.91M by Medicaid between Dec 2018 and Oct 2021, across 3 billing codes. Its largest line is T1016, Case management, each 15 minutes — 100% of everything it billed.

33Billing provider infoDIRECT CARE PRENATAL LLC
MILWAUKEE, WI 53225

33aNPI1184100240assigned 07/12/2018

33bProvider typeCase Management Agency

28Total paid$1.91M

24GClaims24,697

24DCodes billed3

24AFirst – last monthDec 2018 – Oct 2021

Compared with peers

Next to other Case Management Agency providers in Wisconsin

Rank by total paid#43 of 156

Median peer was paid$578K

This provider vs. median3.3×

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 T1016 with only 3 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	68	$4K
2019	5,636	$395K
2020	8,600	$658K
2021	10,393	$852K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1016	Case management, each 15 minutes	100%	24,663	4,562	$1.91M
H1002	Prenatal care, at risk enhanced service; care coordination	<1%	17	17	$829.43
H1000	Prenatal care, at-risk assessment	<1%	17	17	$686.80

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.

From NPPES

Who's on the registration

Authorized officialFERGUSON-CALLAHAN, DETRA (OWNER)