4 GENESIS PRIMARY HOME CARE, LLC
NPI: 1508211970
· MCALLEN, TX 78504
· Home Health Agency
· NPI assigned 05/04/2016
Billing Flags
· Automated signals — not evidence of fraud
Single-Code Concentration
90% of spending on code S5125 with only 3 total codes billed. Highly concentrated billing profile.
$16.53M
Total Medicaid Paid
Provider Details
| Authorized Official | MIRANDA, MANUEL (ADMINISTRATOR-OWNER) |
| NPI Enumeration Date | 05/04/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
136 |
$9K |
| 2020 |
24,571 |
$950K |
| 2021 |
68,071 |
$2.70M |
| 2022 |
91,074 |
$4.09M |
| 2023 |
97,501 |
$4.26M |
| 2024 |
88,453 |
$4.53M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5125 |
Attendant care services; per 15 minutes |
309,478 |
11,440 |
$14.90M |
| 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) |
39,533 |
1,346 |
$878K |
| T1005 |
Respite care services, up to 15 minutes |
20,795 |
983 |
$755K |