VALLEY MEDICAL FACILITIES, INC.
NPI: 1316063068
· SEWICKLEY, PA 15143
· Case Management Agency
· NPI assigned 03/22/2007
Billing Flags
· Automated signals — not evidence of fraud
Single-Code Concentration
95% of spending on code T1017 with only 2 total codes billed. Highly concentrated billing profile.
$4.94M
Total Medicaid Paid
12,303
Beneficiary Records
Provider Details
| Authorized Official | RANDALL, BRYAN (VICE PRESIDENT CFO) |
| NPI Enumeration Date | 03/22/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
31 |
$3K |
| 2020 |
2,074 |
$190K |
| 2021 |
9,077 |
$1.05M |
| 2022 |
9,009 |
$1.19M |
| 2023 |
8,978 |
$1.37M |
| 2024 |
7,394 |
$1.14M |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| T1017 |
Targeted case management, each 15 minutes |
34,658 |
11,525 |
$4.68M |
| H0038 |
Self-help/peer services, per 15 minutes |
1,905 |
778 |
$262K |