SIMCHA, INC.
NPI: 1245883024
· MCALLEN, TX 78501
· Adult Day Care Clinic/Center
· NPI assigned 07/19/2019
Billing Flags
· Automated signals — not evidence of fraud
Single-Code Concentration
100% of spending on code S5101 with only 1 total codes billed. Highly concentrated billing profile.
$2.97M
Total Medicaid Paid
Provider Details
| Authorized Official | MATA, RICARDO (DIRECTOR) |
| NPI Enumeration Date | 07/19/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
1,056 |
$17K |
| 2021 |
8,067 |
$881K |
| 2022 |
6,265 |
$831K |
| 2023 |
5,147 |
$666K |
| 2024 |
4,067 |
$574K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5101 |
Day care services, adult; per half day |
24,602 |
5,087 |
$2.97M |