Community Action South Eastern WV

Community Action South Eastern WV was paid $2.29M by Medicaid between Jan 2018 and Nov 2024, across 3 billing codes. Its largest line is T1016, Case management, each 15 minutes — 99% of everything it billed.

33Billing provider infoCOMMUNITY ACTION SOUTH EASTERN WV
BLUEFIELD, WV 24701

33aNPI1457451627assigned 09/25/2006

33bProvider typeHome Health Agency

28Total paid$2.29M

24GClaims35,724

24DCodes billed3

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Home Health Agency providers in West Virginia

Rank by total paid#22 of 75

Median peer was paid$1.10M

This provider vs. median2.1×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Auditor's notes

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

Single-Code Concentration99% of spending on code T1016 with only 3 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	3,700	$277K
2019	979	$81K
2020	3,989	$294K
2021	5,644	$389K
2022	6,742	$466K
2023	8,327	$437K
2024incomplete	6,343	$350K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1016	Case management, each 15 minutes	99%	35,403	12,834	$2.27M
S5190	Wellness assessment, performed by non-physician	1.2%	307	301	$28K
S9445	Patient education, not otherwise classified, non-physician provider, individual, per session	<1%	14	14	$518.52

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.

From NPPES

Who's on the registration

Authorized officialJOHNSON, BRENDA (PROGRAM DIRECTOR)

Same official

Other billing entities under JOHNSON, BRENDA

Full network →

Provider	Location	Paid
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Ranchotherapy, INC.	Van Buren, AR	$8K

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.