1396946505

1396946505 was paid $27.43M by Medicaid between Jan 2018 and Nov 2020, across 1 billing code. Its largest line is H0017, Behavioral health; residential (hospital residential treatment program), without room and board, per diem — 100% of everything it billed.

33Billing provider info1396946505

33aNPI1396946505

33bProvider type—

28Total paid$27.43M

24GClaims6,205

24DCodes billed1

24AFirst – last monthJan 2018 – Nov 2020

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Single-Code Concentration100% of spending on code H0017 with only 1 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	2,337	$9.68M
2019	2,126	$9.24M
2020	1,742	$8.51M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
H0017	Behavioral health; residential (hospital residential treatment program), without room and board, per diem	100%	6,205	1,065	$27.43M

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.