Medicaid Provider Spending

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

FOUCHA, JAMES

NPI: 1568767861 · NEW ORLEANS, LA 70116 · Community Health Worker · NPI assigned 01/18/2011

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

100% of spending on code T1019 with only 2 total codes billed. Highly concentrated billing profile.

$3.39M
Total Medicaid Paid
54,567
Total Claims
2,524
Beneficiaries
2
Codes Billed
2018-01
First Month
2022-10
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 13,433 $629K
2019 13,249 $592K
2020 10,680 $751K
2021 9,543 $714K
2022 7,662 $704K

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) 53,925 2,500 $3.38M
S5125 Attendant care services; per 15 minutes 642 24 $10K