PETTIS COUNTY ASSISTED LIVING, L.L.C.
NPI: 1568821965
· SEDALIA, MO 65301
· Assisted Living Facility (Mental Illness)
· NPI assigned 02/15/2016
Billing Flags
· Automated signals — not evidence of fraud
Single-Code Concentration
98% of spending on code T1019 with only 2 total codes billed. Highly concentrated billing profile.
$3.34M
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: DESTEFANE, RICHARD
| Provider | City | State | Total Paid |
|---|
| FOUR SEASONS IN HOME SERVICES, LLC |
CLINTON |
MO |
$17.94M |
| CEDARS OF LIBERTY HEALTH CARE CENTER, L.L.C. |
LIBERTY |
MO |
$3.15M |
| FOUR SEASONS IN HOME SERVICES,LLC |
CLINTON |
MO |
$1.11M |
| LEVERING REGIONAL HEALTH CARE CENTER, LLC |
HANNIBAL |
MO |
$364K |
| GREENVILLE HEALTH CARE CENTER, L.L.C. |
GREENVILLE |
MO |
$48K |
| NATHAN RICHARD HEALTH CARE CENTER, LLC |
NEVADA |
MO |
$26K |
| FOUR SEASONS IN HOME SERVICES,LLC |
CLINTON |
MO |
$22K |
| PORTAGEVILLE HEALTH CARE CENTER, L.L.C. |
PORTAGEVILLE |
MO |
$17K |
| MMA HEALTHCARE OF VIBURNUM, INC. |
VIBURNUM |
MO |
$10K |
| EDGEWOOD MANOR HEALTH CARE CENTER, L.L.C. |
RAYTOWN |
MO |
$5K |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,058 |
$224K |
| 2019 |
1,702 |
$331K |
| 2020 |
2,583 |
$673K |
| 2021 |
2,459 |
$635K |
| 2022 |
2,265 |
$707K |
| 2023 |
1,770 |
$470K |
| 2024 |
1,013 |
$304K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total 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) |
11,042 |
6,588 |
$3.27M |
| T1001 |
Nursing assessment / evaluation |
1,808 |
1,673 |
$70K |