Medicaid Provider Spending

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

A PHYSICIANS HOME CARE

NPI: 1417486531 · COLORADO SPRINGS, CO 80907 · In Home Supportive Care Agency · NPI assigned 06/12/2017

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

95% of spending on code H0038 with only 3 total codes billed. Highly concentrated billing profile.

$247.92M
Total Medicaid Paid
989,004
Total Claims
37,074
Beneficiaries
3
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialGUSTAFSON, ERIC (OFFICE ADMISTRATOR)
NPI Enumeration Date06/12/2017

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 4,072 $7.02M
2019 8,545 $12.44M
2020 64,002 $19.17M
2021 248,490 $28.60M
2022 188,097 $44.50M
2023 217,121 $60.61M
2024 258,677 $75.58M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
H0038 Self-help/peer services, per 15 minutes 789,149 29,231 $234.42M
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) 169,544 6,278 $12.14M
S5130 Homemaker service, nos; per 15 minutes 30,311 1,565 $1.37M