Medicaid Provider Spending

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

SUNNYHILL INC

NPI: 1518329390 · DE SOTO, MO 63020 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI assigned 03/22/2016

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

97% of spending on code T1019 with only 2 total codes billed. Highly concentrated billing profile.

$1.40M
Total Medicaid Paid
3,671
Total Claims
2,262
Beneficiaries
2
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialJAMES, VICTORIA (PRESIDENT / CEO)
NPI Enumeration Date03/22/2016

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 222 $80K
2019 463 $145K
2020 613 $215K
2021 770 $238K
2022 767 $288K
2023 440 $230K
2024 396 $201K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
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) 3,107 1,718 $1.36M
T1001 Nursing assessment / evaluation 564 544 $42K