Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

GMC PHC SERVICES, INC.

NPI: 1376736892 · MCALLEN, TX 78504 · Home Health Agency · NPI assigned 08/20/2007

Billing Flags · Automated signals — not evidence of fraud
Single-Code Concentration

97% of spending on code S5125 with only 3 total codes billed. Highly concentrated billing profile.

$11.45M
Total Medicaid Paid
223,239
Total Claims
8,041
Beneficiaries
3
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialSUAREZ, MARISELA (OFFICE MANAGER)
NPI Enumeration Date08/20/2007

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 383 $203K
2019 2,697 $286K
2020 18,814 $859K
2021 55,730 $2.56M
2022 52,226 $2.57M
2023 47,382 $2.45M
2024 46,007 $2.52M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
S5125 Attendant care services; per 15 minutes 210,478 7,506 $11.06M
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) 7,471 263 $232K
T1005 Respite care services, up to 15 minutes 5,290 272 $159K