CLINICAL RESOURCE MANAGEMENT, LLC
NPI: 1295357697
· ROCHESTER, PA 15074
· Mental Illness Community Based Residential Treatment Facility
· NPI assigned 05/08/2020
Billing Flags
· Automated signals — not evidence of fraud
Single-Code Concentration
95% of spending on code H0037 with only 2 total codes billed. Highly concentrated billing profile.
$1.61M
Total Medicaid Paid
Provider Details
| Authorized Official | WEST, ANDRE (OWNER/CEO) |
| NPI Enumeration Date | 05/08/2020 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
419 |
$719K |
| 2024 |
310 |
$894K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0037 |
Community psychiatric supportive treatment program, per diem |
525 |
179 |
$1.54M |
| T2048 |
Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem |
204 |
70 |
$77K |